Provider Demographics
NPI:1619785599
Name:WARE, DEMARIO
Entity type:Individual
Prefix:
First Name:DEMARIO
Middle Name:
Last Name:WARE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2378 WALDEN GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-1431
Mailing Address - Country:US
Mailing Address - Phone:513-990-7345
Mailing Address - Fax:
Practice Address - Street 1:6100 CHANNINGWAY BLVD STE 605
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-2999
Practice Address - Country:US
Practice Address - Phone:614-626-8464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.191000101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)