Provider Demographics
NPI:1093167140
Name:WILLS, KARRAH NICOLE (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:KARRAH
Middle Name:NICOLE
Last Name:WILLS
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:KARRAH
Other - Middle Name:NICOLE
Other - Last Name:WILLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:4629 AICHOLTZ ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244
Mailing Address - Country:US
Mailing Address - Phone:513-732-8800
Mailing Address - Fax:
Practice Address - Street 1:8479 S MASON MONTGOMERY RD STE 4
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-4005
Practice Address - Country:US
Practice Address - Phone:513-443-8139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.18011041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical