Healthcare Provider Details

I. General information

NPI: 1154247559
Provider Name (Legal Business Name): HANNA KANCHERLA LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 OUTERBELT ST
COLUMBUS OH
43213-1529
US

IV. Provider business mailing address

201 OUTERBELT ST
COLUMBUS OH
43213-1529
US

V. Phone/Fax

Practice location:
  • Phone: 614-857-0722
  • Fax: 614-490-0750
Mailing address:
  • Phone: 614-857-0722
  • Fax: 614-490-0705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberS.2614220
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: