Healthcare Provider Details

I. General information

NPI: 1619804887
Provider Name (Legal Business Name): RAY JEAN SANTOS MSW, LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6252 RAYTEE TER
CINCINNATI OH
45230-1509
US

IV. Provider business mailing address

6252 RAYTEE TER
CINCINNATI OH
45230-1509
US

V. Phone/Fax

Practice location:
  • Phone: 513-300-8113
  • Fax:
Mailing address:
  • Phone: 513-300-8113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1100163
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: