Healthcare Provider Details

I. General information

NPI: 1578247458
Provider Name (Legal Business Name): CHLOE ELYSE OLEYAR LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 S CLINTON ST
THE PLAINS OH
45780-1269
US

IV. Provider business mailing address

PO BOX 188
CHILLICOTHEE OH
45601-0188
US

V. Phone/Fax

Practice location:
  • Phone: 740-249-4318
  • Fax: 740-249-4330
Mailing address:
  • Phone: 740-773-4366
  • Fax: 740-773-4426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2608664
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: