Healthcare Provider Details

I. General information

NPI: 1457851784
Provider Name (Legal Business Name): ZACHARY USMANI MSW, LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 04/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 INDIANOLA AVE
COLUMBUS OH
43201-2118
US

IV. Provider business mailing address

1515 INDIANOLA AVE
COLUMBUS OH
43201-2118
US

V. Phone/Fax

Practice location:
  • Phone: 614-294-2661
  • Fax:
Mailing address:
  • Phone: 614-294-2661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: