1720477144 NPI number — THERAPYWORKS CINCINNATI, LLC

Table of content: (NPI 1720477144)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720477144 NPI number — THERAPYWORKS CINCINNATI, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERAPYWORKS CINCINNATI, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720477144
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4757 CORNELL RD STE 4A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLUE ASH
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45241-7400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-489-4919
Provider Business Mailing Address Fax Number:
888-316-2604

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4757 CORNELL RD STE 4A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLUE ASH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45241-7400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-489-4919
Provider Business Practice Location Address Fax Number:
888-316-2604
Provider Enumeration Date:
01/22/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STEENBERGEN
Authorized Official First Name:
CARRIE
Authorized Official Middle Name:
ELIZABETH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
513-349-4919

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: 3541 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QH0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: 7492 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)