Provider Demographics
NPI:1821734153
Name:YOUSE, ELIZABETH PATCHEN (LISW-S)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:PATCHEN
Last Name:YOUSE
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 1:1670 UPHAM DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1250
Mailing Address - Country:US
Mailing Address - Phone:614-487-5200
Mailing Address - Fax:
Practice Address - Street 1:1619 ZOLLINGER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2905
Practice Address - Country:US
Practice Address - Phone:614-487-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1.1100026-SUPV101YM0800X
OHI1100026-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health