Healthcare Provider Details

I. General information

NPI: 1578097820
Provider Name (Legal Business Name): KATIE LYNN SPENCER LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE ARRINGTON

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N YELLOW SPRINGS ST
SPRINGFIELD OH
45504-2650
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 400
CINCINNATI OH
45212-2600
US

V. Phone/Fax

Practice location:
  • Phone: 833-510-4357
  • Fax: 866-459-6532
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2002037-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: