Healthcare Provider Details

I. General information

NPI: 1891247938
Provider Name (Legal Business Name): NICHOLAS JOSEPH SCHUH LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 PLEASANT AVE
HAMILTON OH
45015-1135
US

IV. Provider business mailing address

2250 PLEASANT AVE
HAMILTON OH
45015-1135
US

V. Phone/Fax

Practice location:
  • Phone: 513-868-1562
  • Fax: 513-868-1415
Mailing address:
  • Phone: 513-868-1562
  • Fax: 513-868-1415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1600169
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: