Provider Demographics
NPI:1336118694
Name:CISLER, DAVID NELSON (MA, LSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:NELSON
Last Name:CISLER
Suffix:
Gender:M
Credentials:MA, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 FORSHEY RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-8619
Mailing Address - Country:US
Mailing Address - Phone:740-374-5419
Mailing Address - Fax:
Practice Address - Street 1:2121 7TH ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3803
Practice Address - Country:US
Practice Address - Phone:304-485-1721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-0019689104100000X
WVAP00939763104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker