Provider Demographics
NPI:1316211295
Name:BYERS, CORINNE MARIE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:MARIE
Last Name:BYERS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MAYBANK CT
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1735
Mailing Address - Country:US
Mailing Address - Phone:614-551-7208
Mailing Address - Fax:
Practice Address - Street 1:1414 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1505
Practice Address - Country:US
Practice Address - Phone:614-251-0103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS06003481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical