Provider Demographics
NPI:1992801377
Name:LEARNER, CELESTE ELLEN (LISW)
Entity type:Individual
Prefix:MS
First Name:CELESTE
Middle Name:ELLEN
Last Name:LEARNER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E BROAD ST
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3430
Mailing Address - Country:US
Mailing Address - Phone:614-466-6583
Mailing Address - Fax:614-644-5331
Practice Address - Street 1:157 W CEDAR ST
Practice Address - Street 2:B-3
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2564
Practice Address - Country:US
Practice Address - Phone:330-434-2062
Practice Address - Fax:330-434-0783
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00036881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLESW26341Medicare ID - Type Unspecified