Provider Demographics
NPI:1194425553
Name:CLEARY, JOSEPH CURTIS (SWT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CURTIS
Last Name:CLEARY
Suffix:
Gender:M
Credentials:SWT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 HARRISON AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1346
Mailing Address - Country:US
Mailing Address - Phone:614-940-4868
Mailing Address - Fax:
Practice Address - Street 1:929 HARRISON AVE STE 304
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1346
Practice Address - Country:US
Practice Address - Phone:614-940-4868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2302884-TRNE1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS.2302884-TRNEOtherOHIO COUNSELOR, SOCIAL WORKER & MARRIAGE AND FAMILY THERAPIST BOARD