MEDICARE: KRISTINA CLINGAN MSW, 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	104100000X	Social Worker	S. 0600623	OH

General Provider Information

NPI Number	:	1386008480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA CLINGAN MSW, LSW

Provider Business Mailing Address
First Line	:	6076 SILVERWOOD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-2823
Country	:	US
Telephone Number	:	740-417-2805
Fax Number	:

Provider Business Practice Location Address
First Line	:	6076 SILVERWOOD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-2823
Country	:	US
Telephone Number	:	740-417-2805
Fax Number	:

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

Provider Enumeration Date	:	04/05/2016
Last Update Date	:	06/10/2026

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