Healthcare Provider Details

I. General information

NPI: 1477879559
Provider Name (Legal Business Name): ELLEN E. SEWARD MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 CLAIREDAN DR
POWELL OH
43065-8064
US

IV. Provider business mailing address

824 BOWTOWN RD
DELAWARE OH
43015-9661
US

V. Phone/Fax

Practice location:
  • Phone: 614-396-5665
  • Fax:
Mailing address:
  • Phone: 740-369-7688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI 0900354
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: