MEDICARE: PARIS LINDSEY-WADE 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	104100000X	Social Worker	I.2405628	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871181909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARIS LINDSEY-WADE LISW

Provider Business Mailing Address
First Line	:	5510 WESTERVILLE CROSSING DR
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-9630
Country	:	US
Telephone Number	:	220-219-6059
Fax Number	:

Provider Business Practice Location Address
First Line	:	2720 AIRPORT DR STE 110
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-2219
Country	:	US
Telephone Number	:	614-446-5396
Fax Number	:

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

Provider Enumeration Date	:	01/05/2021
Last Update Date	:	03/06/2025

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