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NPI Code Detail

MEDICARE: MS. SUSAN MARIE MOCNIAK LISW, CDCA

MEDICARE: MS. SUSAN MARIE MOCNIAK LISW, CDCA
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-1450715OH
2101YA0400XAddiction (Substance Use Disorder) CounselorLCDC.141185-3OH

General Provider Information

NPI Number : 1598181240
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN MARIE MOCNIAK LISW, CDCA
Provider Business Mailing Address
First Line : 3536 WENWOOD DR
Second Line :
City : HILLIARD
State : OH
Zip : 43026-2467
Country : US
Telephone Number : 614-354-6962
Fax Number :
Provider Business Practice Location Address
First Line : 21 E STATE ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-4281
Country : US
Telephone Number : 574-546-1900
Fax Number : 574-546-1999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2014
Last Update Date : 03/02/2026

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