Provider Demographics
NPI:1952849937
Name:PONZI, MARIA R (MSW, LISW-S)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:R
Last Name:PONZI
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 EWING RD
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-3216
Mailing Address - Country:US
Mailing Address - Phone:330-727-8281
Mailing Address - Fax:
Practice Address - Street 1:733 EWING RD
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-3216
Practice Address - Country:US
Practice Address - Phone:330-727-8281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1601246104100000X
PASW137188104100000X
OHI.2203463-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker