Healthcare Provider Details

I. General information

NPI: 1770081838
Provider Name (Legal Business Name): RACHEL M BUSKIRK LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N COURT ST
CIRCLEVILLE OH
43113-1087
US

IV. Provider business mailing address

7964 US HIGHWAY 22 E
CIRCLEVILLE OH
43113-9471
US

V. Phone/Fax

Practice location:
  • Phone: 740-500-4460
  • Fax:
Mailing address:
  • Phone: 740-412-5210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2608021
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: