Provider Demographics
NPI:1871740951
Name:MARIANO, ASHLEY SHAWNTEL (LSW)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:SHAWNTEL
Last Name:MARIANO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 JAVIT CT
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2409
Mailing Address - Country:US
Mailing Address - Phone:330-793-2487
Mailing Address - Fax:330-793-4559
Practice Address - Street 1:142 JAVIT CT
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2409
Practice Address - Country:US
Practice Address - Phone:330-793-2487
Practice Address - Fax:330-793-2487
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS 0800610104100000X
OHS0800610104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker