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General NPI Number Information
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NPI Number | 1891942116
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Entity Type | Organization
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Legal Business Name | MARTHA MCLEOD COUNSELING SERVICE
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 211 WOOLPER AVE
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City | CINCINNATI
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State | OH
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Zip | 45220-1217
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Country | US
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Telephone | 513-221-8623
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Fax | 513-221-8623
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Provider Business Mailing Address
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Address Line | 211 WOOLPER AVE
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City | CINCINNATI
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State | OH
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Zip | 45220-1217
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Country | US
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Telephone | 513-221-8623
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Fax | 513-221-8623
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Authorized Official
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Title or Position | LICENSED INDEPENDENT SOCIAL WRKER
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Name | MS. MARTHA ELIZABETH MCLEOD
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Credential | MA, LISW, LCSW
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Telephone | 513-221-8623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | I4537
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License Number State | OH
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