Healthcare Provider Details

I. General information

NPI: 1588311401
Provider Name (Legal Business Name): KEIASHA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 E MEHRING WAY UNIT 805
CINCINNATI OH
45202-3528
US

IV. Provider business mailing address

621 E MEHRING WAY UNIT 805
CINCINNATI OH
45202-3528
US

V. Phone/Fax

Practice location:
  • Phone: 513-601-2138
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2410514
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: