Healthcare Provider Details

I. General information

NPI: 1316211295
Provider Name (Legal Business Name): CORINNE MARIE BYERS LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2012
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 S YEARLING RD
WHITEHALL OH
43213-2800
US

IV. Provider business mailing address

675 S YEARLING RD
WHITEHALL OH
43213-3084
US

V. Phone/Fax

Practice location:
  • Phone: 614-417-5100
  • Fax:
Mailing address:
  • Phone: 614-551-7208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI1302031
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: