Healthcare Provider Details

I. General information

NPI: 1952362162
Provider Name (Legal Business Name): DENISE A ESTILL LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 MAIN ST
COSHOCTON OH
43812-1615
US

IV. Provider business mailing address

2845 BELL ST
ZANESVILLE OH
43701-1720
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-4470
  • Fax: 740-622-5580
Mailing address:
  • Phone: 740-454-9766
  • Fax: 740-588-6452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI9557
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: