MEDICARE: JONATHAN SHERMAN

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.2103094	OH

General Provider Information

NPI Number	:	1871087791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN SHERMAN

Provider Business Mailing Address
First Line	:	1385 KING AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-2220
Country	:	US
Telephone Number	:	614-226-7719
Fax Number	:

Provider Business Practice Location Address
First Line	:	1385 KING AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-2220
Country	:	US
Telephone Number	:	614-226-7719
Fax Number	:	614-437-7142

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

Provider Enumeration Date	:	06/15/2018
Last Update Date	:	09/20/2022

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