MEDICARE: EAST CENTRAL OHIO EDUCATIONAL SERVICE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1043163900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST CENTRAL OHIO EDUCATIONAL SERVICE CENTER

Provider Business Mailing Address
First Line	:	834 E HIGH AVE
Second Line	:
City	:	NEW PHILADELPHIA
State	:	OH
Zip	:	44663-3052
Country	:	US
Telephone Number	:	330-308-9939
Fax Number	:

Provider Business Practice Location Address
First Line	:	55505 NATIONAL RD
Second Line	:
City	:	BRIDGEPORT
State	:	OH
Zip	:	43912-1538
Country	:	US
Telephone Number	:	740-695-9773
Fax Number	:

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. RANDY LUCAS
Credential	:
Telephone Number	:	330-308-9939

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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