Provider Demographics
NPI:1922288299
Name:BEZON, MEI P (LISW-S)
Entity Type:Individual
Prefix:MS
First Name:MEI
Middle Name:P
Last Name:BEZON
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 1:437 HILL RD N
Mailing Address - Street 2:NORTH
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-1157
Mailing Address - Country:US
Mailing Address - Phone:614-834-1919
Mailing Address - Fax:614-834-1920
Practice Address - Street 1:437 HILL RD N
Practice Address - Street 2:NORTH
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1157
Practice Address - Country:US
Practice Address - Phone:614-834-1919
Practice Address - Fax:614-834-1920
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00097711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9111115Medicaid