Healthcare Provider Details

I. General information

NPI: 1275935678
Provider Name (Legal Business Name): ERIN ZIPFEL LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2014
Last Update Date: 05/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1943 W 5TH AVE
COLUMBUS OH
43212-1902
US

IV. Provider business mailing address

1943 W 5TH AVE
COLUMBUS OH
43212-1902
US

V. Phone/Fax

Practice location:
  • Phone: 419-283-6131
  • Fax:
Mailing address:
  • Phone: 419-283-6131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1500596
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.1800978
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: