Healthcare Provider Details

I. General information

NPI: 1952893489
Provider Name (Legal Business Name): AMIE M LAMBERT LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMIE BUTCHER

II. Dates (important events)

Enumeration Date: 05/31/2018
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W BROAD ST
COLUMBUS OH
43204
US

IV. Provider business mailing address

2780 AIRPORT DRIVE SUITE 100 - BILLING/CREDENTIALING DEPT.
COLUMBUS OH
43219-2289
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-2300
  • Fax: 614-645-2333
Mailing address:
  • Phone: 614-859-1906
  • Fax: 614-645-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2102592
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.1802232
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2102592-SUPV
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: