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NPI Code Detail

MEDICARE: MS. MICHELLE VELTA SPANGENBERG LISW-S

MEDICARE:  MS. MICHELLE VELTA SPANGENBERG  LISW-S
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 WorkerI.2204103-SUPVOH
21041C0700XClinical Social WorkerTPSW5545FL

General Provider Information

NPI Number : 1417440132
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE VELTA SPANGENBERG LISW-S
Provider Business Mailing Address
First Line : 105 E ROGER DR
Second Line :
City : TRENTON
State : OH
Zip : 45067-9674
Country : US
Telephone Number : 513-289-7004
Fax Number :
Provider Business Practice Location Address
First Line : 311 MARTIN LUTHER KING DR E
Second Line :
City : CINCINNATI
State : OH
Zip : 45219-2581
Country : US
Telephone Number : 513-475-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2018
Last Update Date : 03/11/2026

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Directions to “ MS. MICHELLE VELTA SPANGENBERG LISW-S” Practice Location

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