Healthcare Provider Details

I. General information

NPI: 1093017444
Provider Name (Legal Business Name): HEATHER N PRICE ACSW, LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER N THACKSTON MSW, LISW-S, C-DBT

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4721 READING RD
CINCINNATI OH
45237-6107
US

IV. Provider business mailing address

4721 READING RD
CINCINNATI OH
45237-6107
US

V. Phone/Fax

Practice location:
  • Phone: 855-577-7284
  • Fax:
Mailing address:
  • Phone: 855-577-7284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.1000908
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1201521.SUPV
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1201521-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: