MEDICARE: JANICE H. LAWSON CCDC III E

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	84035	OH
2	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1609099639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE H. LAWSON CCDC III E

Provider Business Mailing Address
First Line	:	5936 GLENWAY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2009
Country	:	US
Telephone Number	:	513-922-1660
Fax Number	:	513-922-6230

Provider Business Practice Location Address
First Line	:	5936 GLENWAY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2009
Country	:	US
Telephone Number	:	513-922-1660
Fax Number	:	513-922-6230

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	09/11/2025

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