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General NPI Number Information
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NPI Number | 1316400013
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Entity Type | Individual
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Provider Name | CETA GUGLIEMOTTO LCDC III
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Gender | Female
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 895 PARSONS AVE STE B
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City | COLUMBUS
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State | OH
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Zip | 43206-2398
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Country | US
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Telephone | 614-434-6052
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Fax |
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Provider Business Mailing Address
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Address Line | 8350 REYNOLDSWOOD DR
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-9334
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Country | US
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Telephone | 614-307-3983
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCDCIII.161444
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License Number State | OH
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