MEDICARE: KIARRA J MARKS MSW, LSW

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	174400000X	Specialist	S.2410631	OH
2	1041C0700X	Clinical Social Worker	S.2410631	OH
3	171M00000X	Case Manager/Care Coordinator	S.2410631	OH

General Provider Information

NPI Number	:	1326891300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIARRA J MARKS MSW, LSW

Provider Business Mailing Address
First Line	:	224 E 8TH ST APT 703
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-2159
Country	:	US
Telephone Number	:	859-992-9257
Fax Number	:

Provider Business Practice Location Address
First Line	:	224 E 8TH ST APT 703
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-2159
Country	:	US
Telephone Number	:	859-992-9257
Fax Number	:

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

Provider Enumeration Date	:	04/09/2024
Last Update Date	:	06/20/2024

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