1669578621 NPI number — MS. SHARON SMITH SAIA MSW

Table of content: MS. SHARON SMITH SAIA MSW (NPI 1669578621)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669578621 NPI number — MS. SHARON SMITH SAIA MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAIA
Provider First Name:
SHARON
Provider Middle Name:
SMITH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669578621
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1188 ROSEBANK DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-848-3783
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5151 REED RD
Provider Second Line Business Practice Location Address:
BLDG C SUITE 128 CENTRAL OHIO BEHAVIORAL MEDICINE INC
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-538-8300
Provider Business Practice Location Address Fax Number:
614-538-1656
Provider Enumeration Date:
09/16/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  I4523 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)