MEDICARE: LEEANNE E. MAGER

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	1041C0700X	Clinical Social Worker	S.2512331	OH

General Provider Information

NPI Number	:	1598303950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEEANNE E. MAGER

Provider Business Mailing Address
First Line	:	6770 CINCINNATI DAYTON RD STE 208
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9318
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6770 CINCINNATI DAYTON RD STE 208
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9318
Country	:	US
Telephone Number	:	855-686-2210
Fax Number	:

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

Provider Enumeration Date	:	12/17/2019
Last Update Date	:	06/29/2026

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