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General NPI Number Information
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NPI Number | 1396477089
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Entity Type | Individual
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Provider Name | RUDESTA EDWARDS-UGIOMOH LISW, LSCSW, LSWIC
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Gender | Female
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 170 NORTHWOODS BLVD STE 210
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City | COLUMBUS
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State | OH
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Zip | 43235-4711
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Country | US
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Telephone | 855-232-4482
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Fax |
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Provider Business Mailing Address
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Address Line | 170 NORTHWOODS BLVD STE 210
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City | COLUMBUS
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State | OH
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Zip | 43235-4711
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Country | US
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Telephone | 855-232-4482
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2506666
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW70004890
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 06834
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904018929
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License Number State | VA
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