Healthcare Provider Details

I. General information

NPI: 1083890677
Provider Name (Legal Business Name): KAREN BERGSIEKER MCGUIRE LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN BERGSIEKER KRINOV

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 07/14/2025
Certification Date: 07/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 EATON AVE
HAMILTON OH
45013
US

IV. Provider business mailing address

1388 TAFT PL
HAMILTON OH
45013-6319
US

V. Phone/Fax

Practice location:
  • Phone: 513-887-5170
  • Fax: 513-887-5186
Mailing address:
  • Phone: 513-659-0154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.0900269-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number258895
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34010402A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12218-123
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.0900269-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: