Healthcare Provider Details
I. General information
NPI: 1881132116
Provider Name (Legal Business Name): CHRISTA PHILLIPS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/07/2017
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1927 EDENBURGH DR E
COLUMBUS OH
43219-1334
US
IV. Provider business mailing address
PO BOX 24521
COLUMBUS OH
43224-0521
US
V. Phone/Fax
- Phone: 614-260-1884
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | S.1701117 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | S.1701117 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | S.1701117 |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | S.1701117 |
| License Number State | OH |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | S.1701117 |
| License Number State | OH |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | S.1701117 |
| License Number State | OH |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | S.1701117 |
| License Number State | OH |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | S.1701117 |
| License Number State | OH |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | S.1701117 |
| License Number State | OH |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | S.1701117 |
| License Number State | OH |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | S.1701117 |
| License Number State | OH |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | S.1701117 |
| License Number State | OH |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | S.1701117 |
| License Number State | OH |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | S.1701117 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
