Provider Demographics
NPI:1821465428
Name:KOTSATOS-WINBUSH, MARIA (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:KOTSATOS-WINBUSH
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 MONCREST DR NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485-1928
Mailing Address - Country:US
Mailing Address - Phone:330-399-1692
Mailing Address - Fax:330-399-1768
Practice Address - Street 1:1461 MONCREST DR NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-1928
Practice Address - Country:US
Practice Address - Phone:330-399-1692
Practice Address - Fax:330-399-1768
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS. 11016651041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool