Provider Demographics
NPI:1427546696
Name:HAZEL-VENRICK, CALI MICHELLE (LISW-S)
Entity type:Individual
Prefix:
First Name:CALI
Middle Name:MICHELLE
Last Name:HAZEL-VENRICK
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:CALI
Other - Middle Name:M
Other - Last Name:HAZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-5123
Mailing Address - Fax:614-293-4890
Practice Address - Street 1:543 TAYLOR AVE FL 3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1278
Practice Address - Country:US
Practice Address - Phone:614-293-5123
Practice Address - Fax:614-293-4890
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2102973-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical