Provider Demographics
NPI:1477589810
Name:ESSIG, MARCIA STROUD (LISW)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:STROUD
Last Name:ESSIG
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 RIVERSIDE DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2551
Mailing Address - Country:US
Mailing Address - Phone:614-481-9053
Mailing Address - Fax:614-481-9103
Practice Address - Street 1:3040 RIVERSIDE DR
Practice Address - Street 2:SUITE 109
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2551
Practice Address - Country:US
Practice Address - Phone:614-481-9053
Practice Address - Fax:614-481-9103
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-0005659101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHESSW21843Medicare ID - Type Unspecified