Provider Demographics
NPI:1225227911
Name:MCINTOSH, ALBERT JAMES (LISW)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:JAMES
Last Name:MCINTOSH
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 1:3759 MERRYMOUND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-1905
Mailing Address - Country:US
Mailing Address - Phone:800-642-4560
Mailing Address - Fax:888-391-5442
Practice Address - Street 1:24100 CHAGRIN BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5535
Practice Address - Country:US
Practice Address - Phone:800-642-4560
Practice Address - Fax:888-391-5442
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-07001191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical