MEDICARE: ROBERT LLOYD YURISKO LISW-S, LICDC-CS

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.2405114-SUPV	OH

General Provider Information

NPI Number	:	1598248015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LLOYD YURISKO LISW-S, LICDC-CS

Provider Business Mailing Address
First Line	:	1470 KING AVE APT 7
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-2127
Country	:	US
Telephone Number	:	614-448-0123
Fax Number	:

Provider Business Practice Location Address
First Line	:	1180 S HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43206-3413
Country	:	US
Telephone Number	:	614-448-0123
Fax Number	:

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

Provider Enumeration Date	:	09/11/2018
Last Update Date	:	03/12/2026

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