Healthcare Provider Details

I. General information

NPI: 1215436829
Provider Name (Legal Business Name): CARLEIGH N CHATFIELD-ISAAC LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2018
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 E STATE ST STE 200
COLUMBUS OH
43215-0109
US

IV. Provider business mailing address

1758 BLUE RUN RD
LUCASVILLE OH
45648-9150
US

V. Phone/Fax

Practice location:
  • Phone: 513-739-5161
  • Fax:
Mailing address:
  • Phone: 513-739-5161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2002126-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: