Healthcare Provider Details

I. General information

NPI: 1164812459
Provider Name (Legal Business Name): MATTHEW MCGLAUGHLIN CLINE LISW I.2608117
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11156 CANAL RD
CINCINNATI OH
45241-5815
US

IV. Provider business mailing address

11156 CANAL RD
CINCINNATI OH
45241-5815
US

V. Phone/Fax

Practice location:
  • Phone: 513-772-6166
  • Fax:
Mailing address:
  • Phone: 513-772-6166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2608117
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: