| Mandella Davis, MSSA, LISW-S | |
|
4998 W Broad St, Columbus, OH 43228-1647 | |
| (330) 441-1549 | |
| Not Available |
| Full Name | Mandella Davis |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 4998 W Broad St, Columbus, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053829218 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | S.1502370 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I.2204170 (* (Not Available)) | Primary |
| Entity Name | Eastway Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811920556 PECOS PAC ID: 1153211065 Enrollment ID: O20040316000785 |
| Mailing Address | Practice Location Address |
|---|---|
| Mandella Davis, MSSA, LISW-S 6183 Wealthy Ln, Dublin, OH 43016-7812 Ph: () - | Mandella Davis, MSSA, LISW-S 4998 W Broad St, Columbus, OH 43228-1647 Ph: (330) 441-1549 |
Andrea L Goehring, LISW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1555 Bethel Rd, Columbus, OH 43220 Phone: 614-442-0664 Fax: 614-442-0620 | |
Mr. Dale James Smith, L.I.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1301 N High St, Columbus, OH 43201 Phone: 614-299-6600 Fax: 614-298-2224 | |
Abbe M Straw, LISW-S Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 918 S Front St, Columbus, OH 43206 Phone: 614-445-8277 | |
Paul Parker Wilkinson, LISW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2400 N 4th St, Columbus, OH 43202 Phone: 614-432-2273 | |
Elenice Gomes, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1810 Sullivant Ave, Columbus, OH 43222 Phone: 614-752-0333 Fax: 614-995-3268 | |
Hope Anthony, MSW, LSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 527 S High St, Columbus, OH 43215 Phone: 614-227-9444 | |
Mary Evans, LISW-S Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6503 E Broad St, Columbus, OH 43213 Phone: 614-355-8160 Fax: 614-355-8180 |