Healthcare Provider Details

I. General information

NPI: 1740741131
Provider Name (Legal Business Name): KIMBERLY NICOLE SENKO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5899 HARRISON AVE MLC 6011
CINCINNATI OH
45248
US

IV. Provider business mailing address

5899 HARRISON AVE MLC 6011
CINCINNATI OH
45248
US

V. Phone/Fax

Practice location:
  • Phone: 513-803-8200
  • Fax: 513-803-8173
Mailing address:
  • Phone: 513-803-8200
  • Fax: 513-803-8173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35.147144
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.147144
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: