Provider Demographics
NPI:1962920876
Name:ADAMIC, MARLAYNA DAWN (MSSA,MSW, LISW-S)
Entity type:Individual
Prefix:
First Name:MARLAYNA
Middle Name:DAWN
Last Name:ADAMIC
Suffix:
Gender:F
Credentials:MSSA,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 1:2845 BELL ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1720
Mailing Address - Country:US
Mailing Address - Phone:740-454-9766
Mailing Address - Fax:740-588-6452
Practice Address - Street 1:254 MAIN ST
Practice Address - Street 2:
Practice Address - City:BYESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43723-1308
Practice Address - Country:US
Practice Address - Phone:740-340-1174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1610096-TRNE104100000X
OHS.1903351104100000X
OHI.2103032-SUPERVISOR1041C0700X
OHI.21030321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0334600Medicaid