Provider Demographics
NPI:1174674923
Name:WILLCOX, ALANSON FRANCIS (LISW)
Entity Type:Individual
Prefix:MR
First Name:ALANSON
Middle Name:FRANCIS
Last Name:WILLCOX
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 WEST CENTRAL
Mailing Address - Street 2:D-3
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1157
Mailing Address - Country:US
Mailing Address - Phone:419-841-1355
Mailing Address - Fax:419-843-8048
Practice Address - Street 1:6800 W CENTRAL AVE
Practice Address - Street 2:D-3
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1135
Practice Address - Country:US
Practice Address - Phone:419-841-1355
Practice Address - Fax:419-843-8048
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00075371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical