Healthcare Provider Details

I. General information

NPI: 1326822651
Provider Name (Legal Business Name): ALEXANDRIA FISTER KISLIAKOV LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRIA FISTER

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 TREMONT RD
UPPER ARLINGTON OH
43221-2040
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-366-8700
  • Fax: 614-685-3081
Mailing address:
  • Phone: 614-366-8700
  • Fax: 614-685-3081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2304732
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: