Provider Demographics
NPI:1629709381
Name:MCGILL, AALIYAH L
Entity type:Individual
Prefix:
First Name:AALIYAH
Middle Name:L
Last Name:MCGILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4145 CHELSEA SQUARE AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4437
Mailing Address - Country:US
Mailing Address - Phone:330-313-9349
Mailing Address - Fax:
Practice Address - Street 1:90 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1629
Practice Address - Country:US
Practice Address - Phone:740-249-4514
Practice Address - Fax:800-480-7578
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2504275-TRNE1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0043725Medicaid