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NPI Code Detail

MEDICARE: CHARLOTTE L. EASTERLING L.I.S.W.

MEDICARE: CHARLOTTE L. EASTERLING L.I.S.W.
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
11041C0700XClinical Social WorkerI 0028650OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558481234
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLOTTE L. EASTERLING L.I.S.W.
Provider Business Mailing Address
First Line : 2005 ASHLAND AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43620-1703
Country : US
Telephone Number : 419-841-7701
Fax Number :
Provider Business Practice Location Address
First Line : 2005 ASHLAND AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43620-1703
Country : US
Telephone Number : 419-841-7701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 02/28/2020

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Directions to “ CHARLOTTE L. EASTERLING L.I.S.W.” Practice Location

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