Basic Information
| Provider Information | |||||||||
| NPI: | 1093327082 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZELL | ||||||||
| FirstName: | ELLIOTT | ||||||||
| MiddleName: | AERON | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 527 S HIGH ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432155602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142279444 | ||||||||
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| Practice Location | |||||||||
| Address1: | 527 S HIGH ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432155602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138967887 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2020 | ||||||||
| LastUpdateDate: | 10/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | S.2005323 | OH | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.