Healthcare Provider Details

I. General information

NPI: 1740106210
Provider Name (Legal Business Name): MND SWPR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5956 BRUNSWICK CT
LIBERTY TOWNSHIP OH
45044-1260
US

IV. Provider business mailing address

3239 JEFFERSON AVE STE 1PMB1014
CINCINNATI OH
45220-2270
US

V. Phone/Fax

Practice location:
  • Phone: 513-580-8058
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAI SHEMSU
Title or Position: OWNER
Credential: MSED, LPCC-S
Phone: 513-580-8058