Provider Demographics
NPI:1477571990
Name:HABIB, YOUSSEF (LISW-S)
Entity Type:Individual
Prefix:MR
First Name:YOUSSEF
Middle Name:
Last Name:HABIB
Suffix:
Gender:M
Credentials:LISW-S
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:HABIB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6605 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1000
Mailing Address - Country:US
Mailing Address - Phone:419-841-7701
Mailing Address - Fax:419-841-1691
Practice Address - Street 1:536 CUSTER DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-3225
Practice Address - Country:US
Practice Address - Phone:419-913-7859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCS.00000536101YA0400X
OH100086901041C0700X
1041C0700X
OHI.00008690101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH29182269002OtherMEDICAL MUTUAL
OH29182269001OtherMEDICAL MUTUAL
OHHA2022651Medicare ID - Type Unspecified
OH29182269001OtherMEDICAL MUTUAL