Provider Demographics
NPI:1477604379
Name:MACKLENAR, ORALEE (LISW-S, CEAP)
Entity Type:Individual
Prefix:MRS
First Name:ORALEE
Middle Name:
Last Name:MACKLENAR
Suffix:
Gender:F
Credentials:LISW-S, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7101
Mailing Address - Country:US
Mailing Address - Phone:419-251-1418
Mailing Address - Fax:419-251-0616
Practice Address - Street 1:2200 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-7101
Practice Address - Country:US
Practice Address - Phone:419-251-1418
Practice Address - Fax:419-251-0616
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00090011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP336280001Medicare UPIN