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NPI Code Detail

MEDICARE: CASEY BOLANOWSKI CSW

MEDICARE: CASEY BOLANOWSKI CSW
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
1104100000XSocial WorkerS.2613518OH

General Provider Information

NPI Number : 1982239299
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY BOLANOWSKI CSW
Provider Business Mailing Address
First Line : 4629 AICHOLTZ RD STE 2
Second Line :
City : CINCINNATI
State : OH
Zip : 45244-1560
Country : US
Telephone Number : 513-752-1555
Fax Number :
Provider Business Practice Location Address
First Line : 4633 AICHOLTZ RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45244-1447
Country : US
Telephone Number : 513-752-1555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2020
Last Update Date : 03/05/2026

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Directions to “ CASEY BOLANOWSKI CSW” Practice Location

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