Provider Demographics
NPI:1750043113
Name:GASTON, NAOMI VICTORIA (LSW, MSSA)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:VICTORIA
Last Name:GASTON
Suffix:
Gender:F
Credentials:LSW, MSSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3339 CHALFANT RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-3433
Mailing Address - Country:US
Mailing Address - Phone:216-551-3344
Mailing Address - Fax:
Practice Address - Street 1:201 E 5TH ST STE 1900
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-4162
Practice Address - Country:US
Practice Address - Phone:216-551-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker