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General NPI Number Information
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NPI Number | 1407771066
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Entity Type | Organization
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Legal Business Name | GEMINI SHORES COUNSELING LLC
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 8977 COLUMBIA RD STE G
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City | LOVELAND
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State | OH
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Zip | 45140-1100
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Country | US
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Telephone | 513-404-4159
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Fax |
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Provider Business Mailing Address
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Address Line | 8903 PEMBROOKE ST
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City | MAINEVILLE
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State | OH
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Zip | 45039-9742
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Country | US
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Telephone | 513-404-4159
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | DR. KERRI D MCKENNA
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Credential | ED.D., MSW, LISW
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Telephone | 513-404-4159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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