MEDICARE: VICTORIA LAMBROU LISW

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	I.2203566	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1588214647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA LAMBROU LISW

Provider Business Mailing Address
First Line	:	3200 ROCHFORT BRIDGE DR E
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-4467
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 ROCHFORT BRIDGE DR E
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-4467
Country	:	US
Telephone Number	:	650-714-8428
Fax Number	:

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

Provider Enumeration Date	:	09/19/2019
Last Update Date	:	08/10/2022

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