Healthcare Provider Details

I. General information

NPI: 1598857724
Provider Name (Legal Business Name): YVONNE PEAY LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 02/27/2023
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 GLENMORE AVE
CINCINNATI OH
45238-2269
US

IV. Provider business mailing address

111 GARFIELD PL
CINCINNATI OH
45202-1946
US

V. Phone/Fax

Practice location:
  • Phone: 513-914-1815
  • Fax:
Mailing address:
  • Phone: 513-510-2148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS-0025130
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.0025130
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: