Provider Demographics
NPI:1609239011
Name:GIOVANNI, ALLYSON ELIZABETH (LCDC III)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:ELIZABETH
Last Name:GIOVANNI
Suffix:
Gender:F
Credentials:LCDC III
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:ELIZABETH
Other - Last Name:GRATZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCDC III
Mailing Address - Street 1:2737 YOUNGSTOWN RD SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-5002
Mailing Address - Country:US
Mailing Address - Phone:330-369-8022
Mailing Address - Fax:
Practice Address - Street 1:2737 YOUNGSTOWN RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-5002
Practice Address - Country:US
Practice Address - Phone:330-369-8022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH121097-3101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)