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NPI Code Detail

MEDICARE: DESHAWN MARTIN SENSABAUGH

MEDICARE: DESHAWN MARTIN SENSABAUGH
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
1171M00000XCase Manager/Care Coordinator
2251S00000XCommunity/Behavioral Health Agency
3172V00000XCommunity Health WorkerOH

General Provider Information

NPI Number : 1548774193
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESHAWN MARTIN SENSABAUGH
Provider Business Mailing Address
First Line : 431 E LIVINGSTON AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-5533
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 431 E LIVINGSTON AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-5533
Country : US
Telephone Number : 614-895-6818
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2017
Last Update Date : 03/15/2022

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Directions to “ DESHAWN MARTIN SENSABAUGH ” Practice Location

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