Provider Demographics
NPI:1598999385
Name:GINGERICH, WILLIAM (LISW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:GINGERICH
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 1:221 FOUNTAIN PL
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-2205
Mailing Address - Country:US
Mailing Address - Phone:937-593-9600
Mailing Address - Fax:937-592-7705
Practice Address - Street 1:8200 STATE ROUTE 366
Practice Address - Street 2:STE 2B
Practice Address - City:RUSSELLS POINT
Practice Address - State:OH
Practice Address - Zip Code:43348-9670
Practice Address - Country:US
Practice Address - Phone:937-589-3330
Practice Address - Fax:815-346-4059
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.09000681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical