Provider Demographics
NPI:1093228223
Name:MALE, ALEXANDER TYLER (MSW, LISW-S)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:TYLER
Last Name:MALE
Suffix:
Gender:M
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 1:911 GRAHAM RD STE 45
Mailing Address - Street 2:BOX #145
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1171
Mailing Address - Country:US
Mailing Address - Phone:216-215-4913
Mailing Address - Fax:
Practice Address - Street 1:4301 DARROW RD STE 1450
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2674
Practice Address - Country:US
Practice Address - Phone:216-264-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.165228101YA0400X
101YA0400X
OHS1802042104100000X
OHI.2304824-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0038984Medicaid