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NPI Code Detail

MEDICARE: JANICE A BEATY LISW

MEDICARE: JANICE A BEATY LISW
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 WorkerI380OH

General Provider Information

NPI Number : 1508030511
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE A BEATY LISW
Provider Business Mailing Address
First Line : 1515 INDIANOLA AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-2118
Country : US
Telephone Number : 614-294-2661
Fax Number :
Provider Business Practice Location Address
First Line : 1515 INDIANOLA AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-2118
Country : US
Telephone Number : 614-294-2661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2008
Last Update Date : 04/22/2008

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Directions to “ JANICE A BEATY LISW” Practice Location

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