Healthcare Provider Details

I. General information

NPI: 1912495193
Provider Name (Legal Business Name): AMY M SEAGER LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 WORTHINGTON WOODS BLVD # 6228
COLUMBUS OH
43085-1568
US

IV. Provider business mailing address

1121 WORTHINGTON WOODS BLVD # 6228
COLUMBUS OH
43085-1568
US

V. Phone/Fax

Practice location:
  • Phone: 740-409-6163
  • Fax:
Mailing address:
  • Phone: 740-409-6163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1801321
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1801321
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: