Ronald L Axt, LISW
Individual provider Active NPI Clinical Social Worker · Dover, OH
NPI 1154536837 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154536837
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I. 0004440 (OH)
- Practice address
- 201 Hospital Dr
Dover, OH 44622-2058 - Phone
- (330) 343-6631
- Fax
- (330) 343-8188
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I. 0004440 | OH | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I. 0004440 | OH | Yes |
Addresses
Primary practice location
201 Hospital Dr
Dover, OH 44622-2058
Mailing address
201 Hospital Dr
Dover, OH 44622-2058
Phone (330) 343-6631
Other providers in Dover, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.