Healthcare Provider Details

I. General information

NPI: 1356255277
Provider Name (Legal Business Name): JOSEPH MCKENZIE BIESIADA ED. S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 STATE ROUTE 132
AMELIA OH
45102-1718
US

IV. Provider business mailing address

421 MISSOURI AVE APT 2
CINCINNATI OH
45226-1335
US

V. Phone/Fax

Practice location:
  • Phone: 513-943-8982
  • Fax:
Mailing address:
  • Phone: 614-915-7218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.02516
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: