Provider Demographics
NPI:1174857452
Name:CHIAO, DE-CHAO RALPH (LSW)
Entity Type:Individual
Prefix:
First Name:DE-CHAO
Middle Name:RALPH
Last Name:CHIAO
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6897 SPRUCE PINE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4366
Mailing Address - Country:US
Mailing Address - Phone:614-806-0898
Mailing Address - Fax:
Practice Address - Street 1:6897 SPRUCE PINE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4366
Practice Address - Country:US
Practice Address - Phone:614-806-0898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-20
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1041C0700X
171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171R00000XOther Service ProvidersInterpreter