Healthcare Provider Details

I. General information

NPI: 1851056402
Provider Name (Legal Business Name): KATERINA ELENA WOODS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 GRAPHICS WAY STE 3100
LEWIS CENTER OH
43035-1123
US

IV. Provider business mailing address

7100 GRAPHICS WAY STE 3100
LEWIS CENTER OH
43035-1123
US

V. Phone/Fax

Practice location:
  • Phone: 740-428-0428
  • Fax: 740-909-4077
Mailing address:
  • Phone: 740-428-0428
  • Fax: 740-909-4077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2107056
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: