Healthcare Provider Details

I. General information

NPI: 1437963998
Provider Name (Legal Business Name): SUHAIL R AHMED LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N LIMESTONE ST
SPRINGFIELD OH
45501-5001
US

IV. Provider business mailing address

150 N LIMESTONE ST
SPRINGFIELD OH
45501-5001
US

V. Phone/Fax

Practice location:
  • Phone: 937-390-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS2411704
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: