Healthcare Provider Details

I. General information

NPI: 1588078521
Provider Name (Legal Business Name): SAMANTHA JAYNE STRAUB MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 FISHINGER RD
COLUMBUS OH
43221-2108
US

IV. Provider business mailing address

1560 FISHINGER RD
COLUMBUS OH
43221-2108
US

V. Phone/Fax

Practice location:
  • Phone: 614-457-7876
  • Fax: 614-457-1040
Mailing address:
  • Phone: 614-457-7876
  • Fax: 614-457-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3788
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW6093774
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: