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NPI Code Detail

MEDICARE: VICKI K NORMAN LCDCIII

MEDICARE: VICKI K NORMAN LCDCIII
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLCDC.031117-3OH
2104100000XSocial WorkerS.1502568OH

General Provider Information

NPI Number : 1780935775
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI K NORMAN LCDCIII
Provider Business Mailing Address
First Line : 1401 STEFFEN AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45215-2338
Country : US
Telephone Number : 513-588-3623
Fax Number : 134-833-0755
Provider Business Practice Location Address
First Line : 8101 HAMILTON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45231-2323
Country : US
Telephone Number : 513-728-7631
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2012
Last Update Date : 06/06/2024

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