Provider Demographics
NPI:1669501953
Name:UNGAR, LOIS C (LISW)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:C
Last Name:UNGAR
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:CHILDREN'S HOSPITAL GUIDANCE CENTER
Mailing Address - Street 2:899 E. BROAD ST 3RD FLOOR
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205
Mailing Address - Country:US
Mailing Address - Phone:614-355-8000
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:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI10571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08258Medicare UPIN