Individual
ELIZABETH E. STAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW CDCA
Contact information
Practice address
131 N. MAIN ST., MARYSVILLE, OH 43040
(937) 642-1254
(937) 642-2806
Mailing address
PO BOX 817, 1521 N. DETROIT ST., WEST LIBERTY, OH 43357-0817
(937) 465-8065
(937) 465-0442
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101076
OH
1041C0700X
Clinical Social Worker
Primary
I.1000277
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MC1705
—
OH
Enumeration date
07/18/2008
Last updated
12/08/2011
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