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NPI Code Detail

MEDICARE: SARAH ELIZABETH HUMPHREY

MEDICARE: SARAH ELIZABETH HUMPHREY
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
11041C0700XClinical Social WorkerOH
2104100000XSocial Worker
31041S0200XSchool Social Worker

General Provider Information

NPI Number : 1376174516
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ELIZABETH HUMPHREY
Provider Business Mailing Address
First Line : 725 CLIFTON COLONY DR APT 9
Second Line :
City : CINCINNATI
State : OH
Zip : 45220-2356
Country : US
Telephone Number : 423-794-9286
Fax Number :
Provider Business Practice Location Address
First Line : 3229 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-3018
Country : US
Telephone Number : 423-794-9286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2020
Last Update Date : 01/28/2020

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