Provider Demographics
NPI:1093997231
Name:REIGNER, ELIZABETH ELLEN (LISW-S)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ELLEN
Last Name:REIGNER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4257 AMARYLLIS DRIVE
Mailing Address - Street 2:UNIT F
Mailing Address - City:SUGARCREEK TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45459-7123
Mailing Address - Country:US
Mailing Address - Phone:937-856-8006
Mailing Address - Fax:
Practice Address - Street 1:6100 E MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-3399
Practice Address - Country:US
Practice Address - Phone:937-554-1639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.17006551041C0700X
OHI95231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical