Healthcare Provider Details

I. General information

NPI: 1578014825
Provider Name (Legal Business Name): JOE WEILER LISW-S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSEPH WEILER LISW-S

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 10/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 VERNON PL
CINCINNATI OH
45219-2414
US

IV. Provider business mailing address

5282 WILLNET DR
CINCINNATI OH
45238-4372
US

V. Phone/Fax

Practice location:
  • Phone: 513-281-7880
  • Fax: 513-281-7884
Mailing address:
  • Phone: 513-281-7880
  • Fax: 513-281-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.0030311
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: