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NPI Code Detail

MEDICARE: CARRIE ANNA LUCARELL LISW

MEDICARE: CARRIE ANNA LUCARELL 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 WorkerI0009036OH

General Provider Information

NPI Number : 1174517544
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE ANNA LUCARELL LISW
Provider Business Mailing Address
First Line : 1495 MORSE RD
Second Line : SUITE B3
City : COLUMBUS
State : OH
Zip : 43229-6478
Country : US
Telephone Number : 614-267-7003
Fax Number : 614-267-7013
Provider Business Practice Location Address
First Line : 4897 KARL RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-5147
Country : US
Telephone Number : 614-846-2588
Fax Number : 614-846-9759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 07/08/2007

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Directions to “ CARRIE ANNA LUCARELL LISW” Practice Location

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