Provider Demographics
NPI:1255968780
Name:MCGILL, ROSALYN (LSW)
Entity type:Individual
Prefix:
First Name:ROSALYN
Middle Name:
Last Name:MCGILL
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SHADY LANE DR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2710
Mailing Address - Country:US
Mailing Address - Phone:567-743-7199
Mailing Address - Fax:
Practice Address - Street 1:1219 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-5836
Practice Address - Country:US
Practice Address - Phone:567-289-2274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH173054101YA0400X
OHS.2005104104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)