Healthcare Provider Details

I. General information

NPI: 1346167491
Provider Name (Legal Business Name): MICHAEL WESSEL LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 MUDDY CREEK RD
CINCINNATI OH
45238-2057
US

IV. Provider business mailing address

3650 MUDDY CREEK RD
CINCINNATI OH
45238-2057
US

V. Phone/Fax

Practice location:
  • Phone: 513-347-0375
  • Fax: 513-347-0376
Mailing address:
  • Phone: 513-347-0375
  • Fax: 513-347-0376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: