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General NPI Number Information
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NPI Number | 1962857029
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Entity Type | Individual
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Provider Name | DARLENE NEAL LISW
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Gender | Female
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 2741 ATLANTIC AVE
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City | CINCINNATI
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State | OH
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Zip | 45209-2001
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Country | US
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Telephone | 513-254-1362
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Fax |
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Provider Business Mailing Address
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Address Line | 2741 ATLANTIC AVE
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City | CINCINNATI
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State | OH
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Zip | 45209-2001
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Country | US
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Telephone | 513-254-1362
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | I.0008902
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.0008902-SUPV
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License Number State | OH
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