Healthcare Provider Details

I. General information

NPI: 1467066597
Provider Name (Legal Business Name): PSYCHWORKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2020
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4015 EXECUTIVE PARK DR STE 215
CINCINNATI OH
45241-2080
US

IV. Provider business mailing address

PO BOX 18951
FAIRFIELD OH
45018-0951
US

V. Phone/Fax

Practice location:
  • Phone: 513-549-0646
  • Fax: 513-854-9962
Mailing address:
  • Phone: 513-549-0646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. RITCHIE V HALL II
Title or Position: LICENSED PSYCHOLOGIST
Credential: PH.D.
Phone: 513-549-0646