Healthcare Provider Details

I. General information

NPI: 1457966137
Provider Name (Legal Business Name): EMILY MAE PATTON LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY MAE SMITH LISW-S

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WARRIOR WAY
CINCINNATI OH
45227-2596
US

IV. Provider business mailing address

1813 US 50
BATAVIA OH
45103-8603
US

V. Phone/Fax

Practice location:
  • Phone: 513-272-7600
  • Fax: 513-527-5991
Mailing address:
  • Phone: 216-630-0576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2304594
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.2304594-SUPV
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2004867
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: