Provider Demographics
NPI:1407925183
Name:CHUKO, BARBARA L (LISW-S)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:CHUKO
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 1:393 WESTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1663
Mailing Address - Country:US
Mailing Address - Phone:614-599-3261
Mailing Address - Fax:614-235-2008
Practice Address - Street 1:2770 E MAIN ST
Practice Address - Street 2:SUITE 7
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-3519
Practice Address - Country:US
Practice Address - Phone:614-599-3261
Practice Address - Fax:614-235-2008
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00302551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW30191Medicare ID - Type Unspecified