MEDICARE: ANGELA M BILLINGSLEA LISW-S

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	104100000X	Social Worker	I.0700020	OH
2	1041C0700X	Clinical Social Worker	I.0700020	OH

General Provider Information

NPI Number	:	1316830813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA M BILLINGSLEA LISW-S

Provider Business Mailing Address
First Line	:	5243 HERONCREEK BLVD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-7626
Country	:	US
Telephone Number	:	614-935-6450
Fax Number	:

Provider Business Practice Location Address
First Line	:	5243 HERONCREEK BLVD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-7626
Country	:	US
Telephone Number	:	614-935-6450
Fax Number	:

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

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	06/02/2025

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Directions to “ ANGELA M BILLINGSLEA LISW-S” Practice Location

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