MEDICARE: ELIZABETH GRACE ENNEKING

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	101YM0800X	Mental Health Counselor		OH

General Provider Information

NPI Number	:	1720946015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH GRACE ENNEKING

Provider Business Mailing Address
First Line	:	5078 ROMOHR RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45244-1021
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1538 GROESBECK ROAD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224
Country	:	US
Telephone Number	:	513-371-5135
Fax Number	:

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

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/26/2026

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Directions to “ ELIZABETH GRACE ENNEKING ” Practice Location

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