MEDICARE: YOSEPH ARAYA 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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1184495442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOSEPH ARAYA LISW

Provider Business Mailing Address
First Line	:	1464 E COOKE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-2157
Country	:	US
Telephone Number	:	614-395-8766
Fax Number	:

Provider Business Practice Location Address
First Line	:	1464 E COOKE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-2157
Country	:	US
Telephone Number	:	614-395-8766
Fax Number	:

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

Provider Enumeration Date	:	01/15/2024
Last Update Date	:	01/15/2024

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