Healthcare Provider Details

I. General information

NPI: 1154250942
Provider Name (Legal Business Name): JESSICA ROSENFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 EATON AVE
HAMILTON OH
45013-1402
US

IV. Provider business mailing address

6456 MILLRACE WAY
WEST CHESTER OH
45069-6625
US

V. Phone/Fax

Practice location:
  • Phone: 513-868-7700
  • Fax:
Mailing address:
  • Phone: 419-560-5966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.02176
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: