Provider Demographics
NPI:1730660028
Name:CATHERINE ELIZABETH BISTER
Entity type:Organization
Organization Name:CATHERINE ELIZABETH BISTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-464-1355
Mailing Address - Street 1:73 FITZ HENRY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1600
Mailing Address - Country:US
Mailing Address - Phone:330-464-6466
Mailing Address - Fax:614-890-5485
Practice Address - Street 1:4400 N HIGH ST STE 4174400N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2635
Practice Address - Country:US
Practice Address - Phone:330-464-6466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty