MEDICARE: BARBARA MANGES LISW, DCSW

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	I0003887	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	165640	OTHER	OH	VALUE OPTIONS

General Provider Information

NPI Number	:	1821147034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA MANGES LISW, DCSW

Provider Business Mailing Address
First Line	:	201 E 5TH ST
Second Line	:	19TH FLOOR
City	:	CINCINNATI
State	:	OH
Zip	:	45202-4152
Country	:	US
Telephone Number	:	513-762-7604
Fax Number	:	513-762-7605

Provider Business Practice Location Address
First Line	:	201 E 5TH ST
Second Line	:	19TH FLOOR
City	:	CINCINNATI
State	:	OH
Zip	:	45202-4152
Country	:	US
Telephone Number	:	513-762-7604
Fax Number	:	513-762-7605

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	03/17/2014

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