Healthcare Provider Details

I. General information

NPI: 1427093004
Provider Name (Legal Business Name): JILL CHIARA M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 HIGHLAND AVE
CINCINNATI OH
45219-2315
US

IV. Provider business mailing address

3001 HIGHLAND AVE
CINCINNATI OH
45219-2315
US

V. Phone/Fax

Practice location:
  • Phone: 513-961-8484
  • Fax: 513-487-3770
Mailing address:
  • Phone: 513-961-8484
  • Fax: 513-487-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number070733-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: