Provider Demographics
NPI:1770585820
Name:GARSON, ALAN S (LISW)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:S
Last Name:GARSON
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 E BELMEADOW LN
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-4220
Mailing Address - Country:US
Mailing Address - Phone:440-338-5014
Mailing Address - Fax:
Practice Address - Street 1:6009 LANDERHAVEN DR
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4192
Practice Address - Country:US
Practice Address - Phone:440-646-0671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI23661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHGASW09861Medicare ID - Type UnspecifiedSOCIAL WORK