Healthcare Provider Details

I. General information

NPI: 1790270015
Provider Name (Legal Business Name): ARMIRA BEECH MANGO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10901 REED HARTMAN HWY STE 119-123
BLUE ASH OH
45242-2831
US

IV. Provider business mailing address

10901 REED HARTMAN HWY STE 119-123
BLUE ASH OH
45242-2831
US

V. Phone/Fax

Practice location:
  • Phone: 513-832-0029
  • Fax: 513-745-0222
Mailing address:
  • Phone: 513-832-0029
  • Fax: 513-745-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.0010654
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: