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NPI Code Detail

MEDICARE: CORRETTA WHYTE LISW

MEDICARE: CORRETTA WHYTE 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
11041C0700XClinical Social WorkerI.1200016-SUPVOH

General Provider Information

NPI Number : 1649622614
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORRETTA WHYTE LISW
Provider Business Mailing Address
First Line : 700 ACKERMAN RD STE 2120
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1559
Country : US
Telephone Number : 614-293-4854
Fax Number : 614-293-8102
Provider Business Practice Location Address
First Line : 1581 DODD DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43210-1257
Country : US
Telephone Number : 614-293-4854
Fax Number : 614-293-8102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2016
Last Update Date : 02/25/2026

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Directions to “ CORRETTA WHYTE LISW” Practice Location

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