Individual
ALYSSA CAROTHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSSA, LSW
Contact information
Practice address
8445 MUNSON RD, MENTOR, OH 44060-2410
(440) 255-1700
(440) 205-2417
Mailing address
8445 MUNSON RD, MENTOR, OH 44060-2410
(440) 255-1700
(440) 205-2417
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1802347
OH
251S00000X
Community/Behavioral Health Agency
S.1802347
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2864093
—
OH
Enumeration date
08/08/2022
Last updated
12/15/2022
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