Healthcare Provider Details

I. General information

NPI: 1326551359
Provider Name (Legal Business Name): SHAUNA B HEYMAN LISW-SUPV
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAUNA B HARRISON

II. Dates (important events)

Enumeration Date: 11/13/2017
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4232 EASTLEA DR
COLUMBUS OH
43214-2852
US

IV. Provider business mailing address

4232 EASTLEA DR
COLUMBUS OH
43214-2852
US

V. Phone/Fax

Practice location:
  • Phone: 614-315-5831
  • Fax:
Mailing address:
  • Phone: 614-315-5831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1101403-S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: