Healthcare Provider Details

I. General information

NPI: 1457140949
Provider Name (Legal Business Name): WESLEY THOMAS PHILLIPS MSW, LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 NIMITZVIEW DR STE 101
CINCINNATI OH
45230-4300
US

IV. Provider business mailing address

10999 REED HARTMAN HWY STE 207
BLUE ASH OH
45242-8301
US

V. Phone/Fax

Practice location:
  • Phone: 513-999-5506
  • Fax: 513-909-2610
Mailing address:
  • Phone: 513-999-5506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2614481
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: