Healthcare Provider Details

I. General information

NPI: 1033822341
Provider Name (Legal Business Name): SIAN LEWIS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2023
Last Update Date: 01/02/2023
Certification Date: 01/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 INDIANOLA AVE STE 107
COLUMBUS OH
43214-1862
US

IV. Provider business mailing address

4770 INDIANOLA AVE STE 107
COLUMBUS OH
43214-1862
US

V. Phone/Fax

Practice location:
  • Phone: 614-371-2303
  • Fax: 800-905-9950
Mailing address:
  • Phone: 614-371-2303
  • Fax: 800-905-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1302711
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: