Healthcare Provider Details

I. General information

NPI: 1386217321
Provider Name (Legal Business Name): MERNE N PRATT MA, LSW, CCM, CDP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9172 NEIL DR
CINCINNATI OH
45231-2915
US

IV. Provider business mailing address

9172 NEIL DR
CINCINNATI OH
45231-2915
US

V. Phone/Fax

Practice location:
  • Phone: 513-835-4024
  • Fax:
Mailing address:
  • Phone: 513-835-4024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberOH3173203
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number4233632
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1430082
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: