Provider Demographics
NPI:1447318324
Name:PANNING, WILLIAM PAUL (LISW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PAUL
Last Name:PANNING
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 RIVERSIDE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2551
Mailing Address - Country:US
Mailing Address - Phone:614-486-7725
Mailing Address - Fax:
Practice Address - Street 1:3040 RIVERSIDE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2551
Practice Address - Country:US
Practice Address - Phone:614-486-7725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 13851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4312801OtherAETNA INSURANCE
OH000000115851OtherANTHEM BLUE CROSS
OH4312801OtherAETNA INSURANCE