Provider Demographics
NPI:1609975168
Name:YOUSSEF, GARY F (MS, IMFT)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:F
Last Name:YOUSSEF
Suffix:
Gender:M
Credentials:MS, IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 WILLYS PKWY
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-2131
Mailing Address - Country:US
Mailing Address - Phone:567-298-1539
Mailing Address - Fax:
Practice Address - Street 1:4417 WILLYS PKWY
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-2131
Practice Address - Country:US
Practice Address - Phone:567-298-1539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45456106H00000X
OHF.2500504106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1609975168Medicaid
CA45456OtherCALIFORNIA BOARD OF BEHAVIORAL SCIENCES
OHF.2500504OtherOHIO COUNSELOR, SOCIAL WORKER AND MARRIAGE AND FAMILY THERAPIST BOARD