Healthcare Provider Details

I. General information

NPI: 1164855045
Provider Name (Legal Business Name): SAMANTHA ROSE FERSKY MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 OFFICE CENTER PL
GAHANNA OH
43230-5317
US

IV. Provider business mailing address

540 OFFICE CENTER PL STE 180
GAHANNA OH
43230-5321
US

V. Phone/Fax

Practice location:
  • Phone: 888-336-1772
  • Fax:
Mailing address:
  • Phone: 216-712-5139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1901782
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: