Healthcare Provider Details

I. General information

NPI: 1689967788
Provider Name (Legal Business Name): CINCINNATI CENTER FOR PSYCHOTHERAPY & PSYCHOANALYSIS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2011
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
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: 513-961-8830
  • Fax: 513-487-3770
Mailing address:
  • Phone: 513-961-8830
  • Fax: 513-487-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: GAIL A BARKER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 513-961-8830