Healthcare Provider Details

I. General information

NPI: 1902129125
Provider Name (Legal Business Name): DULCE HERSHBERGER MSW, LISWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 ROBERTS RD
COLUMBUS OH
43228-9671
US

IV. Provider business mailing address

4937 W BROAD ST
COLUMBUS OH
43228-1646
US

V. Phone/Fax

Practice location:
  • Phone: 513-834-7063
  • Fax: 513-873-1567
Mailing address:
  • Phone: 614-619-0403
  • Fax: 614-619-0403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberI.0900368
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.0900368S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: