MEDICARE: KARELYS ORTIZ SANTIAGO LSW

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	S.2106846	OH

General Provider Information

NPI Number	:	1093504581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARELYS ORTIZ SANTIAGO LSW

Provider Business Mailing Address
First Line	:	15815 MAPLEWOOD AVE
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-3932
Country	:	US
Telephone Number	:	614-423-5833
Fax Number	:

Provider Business Practice Location Address
First Line	:	338 MODESTA RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-4434
Country	:	US
Telephone Number	:	614-423-5833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2025
Last Update Date	:	05/02/2025

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Directions to “ KARELYS ORTIZ SANTIAGO LSW” Practice Location

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