Individual provider Active NPI

Alyssa Maruk, LPC

  • Professional Counselor
  • Toledo, OH
National Provider Identifier
1972010205
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2001608-SUPV Issued in OH
Practice address
123 22ND St
Toledo, OH 43604-2706
Phone
(419) 241-6191
NPI assigned
Jan 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.2001608-SUPV OH Primary
Mental Health Counselor 101YM0800X APP-000112045 OH

Addresses

Primary practice location

123 22ND St
Toledo, OH 43604-2706

Mailing address

3909 Woodley Rd
Toledo, OH 43606-1169

Other names 1

  • Alyssa Grahl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815000166 OH Practitioner - Mental Health Counselor 5698213171 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APP-000112045OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Counselor CurrentSince Apr 27, 2024 Accepting new patients
Harbor Past Accepting new patients

Locations

101 Clinton St
Defiance, OH 43512
Phone (419) 782-4196

3909 Woodley Rd
Toledo, OH 43606
Phone (419) 725-3330

4334 Secor Rd
Toledo, OH 43623
Phone (419) 475-6478

123 22nd St
Toledo, OH 43604
Phone (419) 241-6191

97 Houpt Dr
Upper Sandusky, OH 43351
Phone (419) 731-0720

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1972010205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 WOODLEY RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 22ND ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042706",
            "telephone_number": "419-241-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUK",
        "first_name": "ALYSSA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2001608-SUPV",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "APP-000112045",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "GRAHL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.