1407715782 NPI number — LIZA S PAUL LISW

NPI Number: 1407715782
Health Care Provider/Practitioner: LIZA S PAUL LISW

NPI Number : 1407715782 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407715782",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PAUL",
    "FirstName": "LIZA",
    "MiddleName": "S",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LISW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CAMACHO",
    "OtherFirstName": "LIZA",
    "OtherMiddleName": "S",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3433 AGLER RD STE 2800",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLUMBUS",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "43219-3389",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "614-859-1906",
    "MailingAddressFaxNumber": "614-458-1849",
    "FirstLinePracticeLocationAddress": "1905 PARSONS AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLUMBUS",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "43207-1933",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "614-586-4159",
    "PracticeLocationAddressFaxNumber": "614-586-4252",
    "EnumerationDate": "01/21/2026",
    "LastUpdateDate": "01/21/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "I.1200989-SUPV",
        "LicenseNumberStateCode": "OH",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}