Healthcare Provider Details

I. General information

NPI: 1538551734
Provider Name (Legal Business Name): STEPHANIE S. KRZNARICH LISW-S, LCDC III,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 E MOUND ST STE 110
COLUMBUS OH
43215-5596
US

IV. Provider business mailing address

5011 PINE CREEK DR
WESTERVILLE OH
43081-4849
US

V. Phone/Fax

Practice location:
  • Phone: 614-948-3273
  • Fax: 855-740-2025
Mailing address:
  • Phone: 614-948-3273
  • Fax: 855-740-2025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number081037
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0009193
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: