Healthcare Provider Details

I. General information

NPI: 1558991851
Provider Name (Legal Business Name): COURTNEY STOVER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2020
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W MAIN ST
CIRCLEVILLE OH
43113-1654
US

IV. Provider business mailing address

PO BOX 396
SPRINGBORO OH
45066-0396
US

V. Phone/Fax

Practice location:
  • Phone: 866-534-2639
  • Fax: 800-480-7578
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: