Individual provider Active NPI

Charles Alexander Krizmanich, LSW

  • Social Worker
  • Canton, OH
National Provider Identifier
1164048435
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2411715 Issued in OH
Practice address
2600 Seventh St SW
Canton, OH 44710-1801
Phone
(330) 363-6242
Fax
(330) 453-4263
NPI assigned
Jun 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2411715 OH Primary

Addresses

Primary practice location

2600 Seventh St SW
Canton, OH 44710-1801

Mailing address

30 Northwest Ave Ste 120
Tallmadge, OH 44278-1808
Phone (330) 663-4187

Other practice location 1

2600 Sixth St SW
Canton, OH 44710-1702
Phone (330) 363-7444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.2411715OHMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1164048435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NORTHWEST AVE STE 120",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442781808",
            "telephone_number": "330-663-4187",
            "fax_number": "614-227-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SEVENTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101801",
            "telephone_number": "330-363-6242",
            "fax_number": "330-453-4263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Sixth St SW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447101702",
            "country_code": "US",
            "telephone_number": "330-363-7444",
            "fax_number": "330-363-7770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRIZMANICH",
        "first_name": "CHARLES",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-22",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2411715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.