Provider Demographics
NPI:1699461129
Name:LICHTINGER, PAUL
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:LICHTINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4369 OAKS SHADOW DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-5001
Mailing Address - Country:US
Mailing Address - Phone:614-656-7025
Mailing Address - Fax:614-503-1599
Practice Address - Street 1:1100 BEECHER XING N STE D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-4565
Practice Address - Country:US
Practice Address - Phone:614-656-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker