MEDICARE: LINDA SUZANNE DEMOSTHENES MSW, LISW-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I.0008352	OH

General Provider Information

NPI Number	:	1790468379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA SUZANNE DEMOSTHENES MSW, LISW-S

Provider Business Mailing Address
First Line	:	1650 ROBINWAY DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-2237
Country	:	US
Telephone Number	:	216-410-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 ROBINWAY DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-2237
Country	:	US
Telephone Number	:	216-410-6300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2023
Last Update Date	:	08/09/2023

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