MEDICARE: MS. CELESTE ELLEN LEARNER 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-0003688	OH

General Provider Information

NPI Number	:	1992801377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CELESTE ELLEN LEARNER LISW

Provider Business Mailing Address
First Line	:	30 E BROAD ST
Second Line	:	11TH FLOOR
City	:	COLUMBUS
State	:	OH
Zip	:	43215-3430
Country	:	US
Telephone Number	:	614-466-6583
Fax Number	:	614-644-5331

Provider Business Practice Location Address
First Line	:	157 W CEDAR ST
Second Line	:	B-3
City	:	AKRON
State	:	OH
Zip	:	44307-2564
Country	:	US
Telephone Number	:	330-434-2062
Fax Number	:	330-434-0783

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	07/08/2007

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