Provider Demographics
NPI:1912315326
Name:MCNAMARA, ASHLEY (LISW-S)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MCNAMARA
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 1:3600 OLENTANGY RIVER RD
Mailing Address - Street 2:BUILDING D. STE 101
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-4505
Mailing Address - Country:US
Mailing Address - Phone:614-285-5040
Mailing Address - Fax:614-633-1240
Practice Address - Street 1:3600 OLENTANGY RIVER RD STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3437
Practice Address - Country:US
Practice Address - Phone:614-285-5040
Practice Address - Fax:614-633-1240
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OHI.100189.SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2846675Medicaid