Provider Demographics
NPI:1396216313
Name:BADAMY, ANNETTE C (LISW MA)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:C
Last Name:BADAMY
Suffix:
Gender:F
Credentials:LISW MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3857 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3752
Mailing Address - Country:US
Mailing Address - Phone:614-607-0980
Mailing Address - Fax:
Practice Address - Street 1:3857 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3752
Practice Address - Country:US
Practice Address - Phone:614-607-0980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1800750104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1473276Medicaid