Healthcare Provider Details

I. General information

NPI: 1134605058
Provider Name (Legal Business Name): ADAM HEMSATH LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2018
Last Update Date: 07/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 E MAIN ST STE 102
COLUMBUS OH
43213-2598
US

IV. Provider business mailing address

7311 CONNOR AVE
CANAL WINCHESTER OH
43110-9355
US

V. Phone/Fax

Practice location:
  • Phone: 614-751-1090
  • Fax:
Mailing address:
  • Phone: 330-440-2591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1802446
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: