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NPI Code Detail

MEDICARE: AMIE RENEE DECHELLIS LISW

MEDICARE: AMIE RENEE DECHELLIS LISW
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1063644367
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIE RENEE DECHELLIS LISW
Provider Business Mailing Address
First Line : 849 DAYSPRING CT
Second Line :
City : TRENTON
State : OH
Zip : 45067-9629
Country : US
Telephone Number : 513-885-2968
Fax Number :
Provider Business Practice Location Address
First Line : 4721 READING RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-6107
Country : US
Telephone Number : 513-242-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2009
Last Update Date : 01/03/2016

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