MEDICARE: MISS ALISON HUMPHREYS 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.1701434	OH

General Provider Information

NPI Number	:	1508417585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ALISON HUMPHREYS LSW

Provider Business Mailing Address
First Line	:	1791 ALUM CREEK DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 S PLUM ST
Second Line	:
City	:	MARYSVILLE
State	:	OH
Zip	:	43040-1631
Country	:	US
Telephone Number	:	937-644-9192
Fax Number	:

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

Provider Enumeration Date	:	09/22/2019
Last Update Date	:	03/15/2026

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