Healthcare Provider Details

I. General information

NPI: 1447863238
Provider Name (Legal Business Name): SHAYLA NICOLE GARMAN QMHS CMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 E DUBLIN GRANVILLE RD STE 222
COLUMBUS OH
43229-3314
US

IV. Provider business mailing address

1395 E DUBLIN GRANVILLE RD STE 222
COLUMBUS OH
43229-3314
US

V. Phone/Fax

Practice location:
  • Phone: 614-487-8758
  • Fax:
Mailing address:
  • Phone: 614-487-8758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2106848
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: