Healthcare Provider Details

I. General information

NPI: 1821828690
Provider Name (Legal Business Name): EVELYN K ACKERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1879 DEERFIELD RD
LEBANON OH
45036-9946
US

IV. Provider business mailing address

1879 DEERFIELD RD
LEBANON OH
45036-9946
US

V. Phone/Fax

Practice location:
  • Phone: 513-695-2900
  • Fax: 513-809-1008
Mailing address:
  • Phone: 513-695-2900
  • Fax: 513-809-1008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: