Provider Demographics
NPI:1336643246
Name:WILKERSON SWEET, CHRISTOFF ASHER (LSW)
Entity Type:Individual
Prefix:
First Name:CHRISTOFF
Middle Name:ASHER
Last Name:WILKERSON SWEET
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:CHRISTINE
Other - Last Name:SWEET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2582 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-3326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2582 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3326
Practice Address - Country:US
Practice Address - Phone:614-278-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1500344104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker