Provider Demographics
NPI:1528041316
Name:YOST, SUSAN M (LISW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:YOST
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2759 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1824
Mailing Address - Country:US
Mailing Address - Phone:614-560-9284
Mailing Address - Fax:
Practice Address - Street 1:2759 PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-1824
Practice Address - Country:US
Practice Address - Phone:614-560-9284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-74121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH235761OtherVALUEOPTIONS
OHYOSW29731Medicare ID - Type Unspecified