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General NPI Number Information
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NPI Number | 1801101969
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Entity Type | Organization
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Legal Business Name | BARB CHUKO LISW LLC
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 09/15/2010
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Provider Practice Location Address
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Address Line | 2770 E MAIN ST STE 7
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City | COLUMBUS
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State | OH
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Zip | 43209-3519
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Country | US
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Telephone | 614-599-3261
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Fax | 614-235-2008
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Provider Business Mailing Address
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Address Line | 2770 E MAIN ST STE 7
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City | COLUMBUS
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State | OH
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Zip | 43209-3519
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Country | US
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Telephone | 614-599-3261
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Fax | 614-235-2008
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BARBARA L CHUKO
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Credential | LISW-SUPV
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Telephone | 61459933261
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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.0030255-SUPV
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License Number State | OH
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