Provider Demographics
NPI:1578696951
Name:FARKAS, ALISA C (LISW)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:C
Last Name:FARKAS
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 1:2100 LYTHAM RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-4632
Mailing Address - Country:US
Mailing Address - Phone:614-290-3581
Mailing Address - Fax:614-355-8018
Practice Address - Street 1:CHILDREN'S HOSPITAL GUIDANCE CENTER
Practice Address - Street 2:899 E. BROAD ST 3RD FLOOR
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205
Practice Address - Country:US
Practice Address - Phone:614-355-8000
Practice Address - Fax:614-355-8018
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OHI00287081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08258Medicare UPIN