Healthcare Provider Details
I. General information
NPI: 1255834677
Provider Name (Legal Business Name): CAITLYN STARCHER LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/12/2018
Last Update Date: 03/20/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1020 DENNISON AVE STE 101
COLUMBUS OH
43201-3497
US
IV. Provider business mailing address
1020 DENNISON AVE STE 101
COLUMBUS OH
43201-3497
US
V. Phone/Fax
- Phone: 614-674-6076
- Fax:
- Phone: 330-718-0743
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | I.1901891-SUPV |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: