Healthcare Provider Details

I. General information

NPI: 1801257308
Provider Name (Legal Business Name): MONICA RENEE WHITEHEAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CINCINNATI CHILDREN'S HOSPITAL 3333 BURNET AVENUE, ML 3015
CINCINNATI OH
45229
US

IV. Provider business mailing address

CINCINNATI CHILDREN'S HOSPITAL 3333 BURNET AVENUE, ML 3015
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4336
  • Fax: 513-636-7756
Mailing address:
  • Phone: 513-636-4336
  • Fax: 513-636-7756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.07762
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberP.07762
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: