Provider Demographics
NPI:1356820021
Name:WERNKE, BETH ALYSON (MSW, LISW-S, CSW)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ALYSON
Last Name:WERNKE
Suffix:
Gender:F
Credentials:MSW, LISW-S, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 CRESTMOOR LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2005
Mailing Address - Country:US
Mailing Address - Phone:859-250-7834
Mailing Address - Fax:
Practice Address - Street 1:431 OHIO PIKE STE 103N
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3372
Practice Address - Country:US
Practice Address - Phone:513-655-7140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY253844104100000X
OHS.1600543104100000X
I.1901847101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker