MEDICARE: LISA MCGANN 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	1041C0700X	Clinical Social Worker	S.2309455	OH

General Provider Information

NPI Number	:	1386296549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MCGANN LSW

Provider Business Mailing Address
First Line	:	230 E TOWN STREET
Second Line	:	SUITE 210
City	:	COLUMBUS
State	:	OH
Zip	:	43215-4657
Country	:	US
Telephone Number	:	614-412-1002
Fax Number	:	614-358-9792

Provider Business Practice Location Address
First Line	:	230 E TOWN STREET
Second Line	:	SUITE 210
City	:	COLUMBUS
State	:	OH
Zip	:	43215-4657
Country	:	US
Telephone Number	:	614-412-1002
Fax Number	:	614-358-9792

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

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	04/16/2024

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Directions to “ LISA MCGANN LSW” Practice Location

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