Healthcare Provider Details

I. General information

NPI: 1053605154
Provider Name (Legal Business Name): BARBARA HANLEY PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3284 N BEND RD SUITE 314
CINCINNATI OH
45239-7688
US

IV. Provider business mailing address

3284 N BEND RD SUITE 314
CINCINNATI OH
45239-7688
US

V. Phone/Fax

Practice location:
  • Phone: 513-481-2432
  • Fax: 513-662-2432
Mailing address:
  • Phone: 513-481-2432
  • Fax: 513-662-2432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number944096
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number84035
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0003334
License Number StateOH

VIII. Authorized Official

Name: BARBARA HANLEY
Title or Position: OWNER
Credential: LISW-S
Phone: 513-841-2432