Healthcare Provider Details

I. General information

NPI: 1801241237
Provider Name (Legal Business Name): NEUROPSYCH CENTER OF GREATER CINCINNATI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4015 EXECUTIVE PARK DR STE 320
CINCINNATI OH
45241-4015
US

IV. Provider business mailing address

4015 EXECUTIVE PARK DR STE 320
CINCINNATI OH
45241-4015
US

V. Phone/Fax

Practice location:
  • Phone: 513-563-0488
  • Fax: 513-563-0428
Mailing address:
  • Phone: 513-563-0488
  • Fax: 513-563-0428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. TIMOTHY SIGWARD
Title or Position: OWNER
Credential: PHD
Phone: 513-563-0488