Provider Demographics
NPI:1033590641
Name:ESPINOZA, AVALON (MSW, LISW-S)
Entity Type:Individual
Prefix:
First Name:AVALON
Middle Name:
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:AVALON
Other - Middle Name:
Other - Last Name:KLEPPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LISW-S
Mailing Address - Street 1:233 S OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-1335
Mailing Address - Country:US
Mailing Address - Phone:614-395-9183
Mailing Address - Fax:844-333-0387
Practice Address - Street 1:500 W WILSON BRIDGE RD STE 75
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2238
Practice Address - Country:US
Practice Address - Phone:614-395-9767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0006091-SUPV101YM0800X
OHI00060911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health