Healthcare Provider Details

I. General information

NPI: 1285800896
Provider Name (Legal Business Name): MEGAN WEINGARTNER LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2008
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6435 E BROAD ST
COLUMBUS OH
43213-1507
US

IV. Provider business mailing address

PO BOX 715194
COLUMBUS OH
43271-5194
US

V. Phone/Fax

Practice location:
  • Phone: 614-355-8160
  • Fax: 614-355-8180
Mailing address:
  • Phone: 614-355-8004
  • Fax: 614-355-0509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.0900300
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: