Provider Demographics
NPI:1265452692
Name:MELOWSKY, SUSAN B (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:B
Last Name:MELOWSKY
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 E HOLLISTER ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-1704
Mailing Address - Country:US
Mailing Address - Phone:513-621-5001
Mailing Address - Fax:513-621-5008
Practice Address - Street 1:26 E HOLLISTER ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1704
Practice Address - Country:US
Practice Address - Phone:513-621-5001
Practice Address - Fax:513-621-5008
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI17881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMESW29931Medicare ID - Type Unspecified