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NPI Code Detail

MEDICARE: LAUREN CZERNIAK LISW

MEDICARE: LAUREN CZERNIAK LISW
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
1104100000XSocial WorkerS.1600832OH
2251S00000XCommunity/Behavioral Health Agency
31041C0700XClinical Social WorkerI.2103102OH

General Provider Information

NPI Number : 1104374958
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN CZERNIAK LISW
Provider Business Mailing Address
First Line : 4159 N HOLLAND SYLVANIA RD STE 205
Second Line :
City : TOLEDO
State : OH
Zip : 43623-4801
Country : US
Telephone Number : 614-674-6076
Fax Number :
Provider Business Practice Location Address
First Line : 4159 N HOLLAND SYLVANIA RD STE 205
Second Line :
City : TOLEDO
State : OH
Zip : 43623-4801
Country : US
Telephone Number : 614-674-6076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2016
Last Update Date : 03/01/2023

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1497221428 — CATHERINE A. BOELLNER LISW, MSW
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Directions to “ LAUREN CZERNIAK LISW” Practice Location

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