Provider Demographics
NPI:1538675327
Name:OVERTURF, WILLIAM MICKY JR (BSW/LSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:MICKY
Last Name:OVERTURF
Suffix:JR
Gender:M
Credentials:BSW/LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2836 LOUISE AVE
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-2464
Mailing Address - Country:US
Mailing Address - Phone:614-273-9143
Mailing Address - Fax:
Practice Address - Street 1:2865 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-2643
Practice Address - Country:US
Practice Address - Phone:614-875-2371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-16
Last Update Date:2017-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1600905104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker