Provider Demographics
NPI:1609835826
Name:AKASHI, AZARIA (PHD)
Entity Type:Individual
Prefix:
First Name:AZARIA
Middle Name:
Last Name:AKASHI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6885 ALLOWAY ST W
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2538
Mailing Address - Country:US
Mailing Address - Phone:614-846-1421
Mailing Address - Fax:614-846-1430
Practice Address - Street 1:130 N PROSPECT ST
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1371
Practice Address - Country:US
Practice Address - Phone:614-846-1421
Practice Address - Fax:614-846-1430
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4885103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP16465Medicare PIN