Healthcare Provider Details

I. General information

NPI: 1326891300
Provider Name (Legal Business Name): KIARRA J MARKS MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 E 8TH ST APT 703
CINCINNATI OH
45202-2159
US

IV. Provider business mailing address

224 E 8TH ST APT 703
CINCINNATI OH
45202-2159
US

V. Phone/Fax

Practice location:
  • Phone: 859-992-9257
  • Fax:
Mailing address:
  • Phone: 859-992-9257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2410631
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberS.2410631
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberS.2410631
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: