Healthcare Provider Details

I. General information

NPI: 1457841702
Provider Name (Legal Business Name): MEGAN ROBENSTINE LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2018
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 W MAIN ST
LANCASTER OH
43130
US

IV. Provider business mailing address

131 W MAIN ST
LANCASTER OH
43130-3719
US

V. Phone/Fax

Practice location:
  • Phone: 800-321-8293
  • Fax: 740-594-9967
Mailing address:
  • Phone: 740-277-6389
  • Fax: 740-277-6382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.1901462
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: