MEDICARE: MS. SHEILA IRENE KAPUR 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 1000349	OH

General Provider Information

NPI Number	:	1629367016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHEILA IRENE KAPUR LISW

Provider Business Mailing Address
First Line	:	1550 OLD HENDERSON RD
Second Line	:	SUITE N245
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3626
Country	:	US
Telephone Number	:	614-715-4245
Fax Number	:	888-974-0261

Provider Business Practice Location Address
First Line	:	1550 OLD HENDERSON RD
Second Line	:	SUITE N245
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3626
Country	:	US
Telephone Number	:	614-715-4245
Fax Number	:	888-974-0261

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

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	03/15/2015

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