Provider Demographics
NPI:1912195363
Name:FOLEY, JAMES (LISW-S)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:FOLEY
Suffix:
Gender:M
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4419 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-1233
Mailing Address - Country:US
Mailing Address - Phone:330-345-8450
Mailing Address - Fax:330-345-5899
Practice Address - Street 1:4419 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1233
Practice Address - Country:US
Practice Address - Phone:330-345-8450
Practice Address - Fax:330-345-5899
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI7261-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical