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General NPI Number Information
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NPI Number | 1982343695
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Entity Type | Organization
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Legal Business Name | INTENTIONAL CONNECTION LLC
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Dates
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Enumeration Date | 06/01/2022
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 1541 MARLOWE AVE APT 1
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City | CINCINNATI
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State | OH
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Zip | 45224-3050
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Country | US
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Telephone | 513-512-2310
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Fax |
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Provider Business Mailing Address
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Address Line | 1541 MARLOWE AVE APT 1
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City | CINCINNATI
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State | OH
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Zip | 45224-3050
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Country | US
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Telephone | 513-512-2310
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Fax |
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Authorized Official
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Title or Position | OWNER/SOCIAL WORK
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Name | MONICA KARREEN BENTON
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Credential | MSW, LSW
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Telephone | 513-512-2310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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