MEDICARE: KARISMA HAZEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013576354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARISMA HAZEL

Provider Business Mailing Address
First Line	:	831 GREER ST APT 3
Second Line	:
City	:	COVINGTON
State	:	KY
Zip	:	41011-1644
Country	:	US
Telephone Number	:	773-885-9194
Fax Number	:

Provider Business Practice Location Address
First Line	:	7373 BROOKCREST DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-3446
Country	:	US
Telephone Number	:	513-202-3507
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2019
Last Update Date	:	03/09/2021

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Directions to “ KARISMA HAZEL ” Practice Location

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