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NPI Code Detail

MEDICARE: WHITNEY MARIE CONRAD MSW, LSW

MEDICARE: WHITNEY MARIE CONRAD MSW, LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerS.1201139OH
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1396257515
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY MARIE CONRAD MSW, LSW
Provider Business Mailing Address
First Line : 1801 WATERMARK DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-7088
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1219 JEFFERSON AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43604-5836
Country : US
Telephone Number : 419-967-0801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2017
Last Update Date : 11/26/2024

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