Provider Demographics
NPI:1376796722
Name:CALHOUN, BERNICE RAEANN (LCSW, ACADC)
Entity Type:Individual
Prefix:MRS
First Name:BERNICE
Middle Name:RAEANN
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:LCSW, ACADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2610
Mailing Address - Country:US
Mailing Address - Phone:513-351-9900
Mailing Address - Fax:
Practice Address - Street 1:1955 DIXIE HWY STE D
Practice Address - Street 2:
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011
Practice Address - Country:US
Practice Address - Phone:859-341-5757
Practice Address - Fax:859-331-4757
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLCADC240049101YA0400X
OHI.1901561104100000X
IDLCSW306351041C0700X, 1041C0700X
KYLCSW2528501041C0700X
ID28600104100000X, 1041C0700X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst