Provider Demographics
NPI:1548611486
Name:HARRISON, HORTENCIA DENISE (LISW, MSW)
Entity Type:Individual
Prefix:
First Name:HORTENCIA
Middle Name:DENISE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LISW, MSW
Other - Prefix:
Other - First Name:HORTENCIA
Other - Middle Name:DENISE
Other - Last Name:ARIZPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 ZOLLINGER RD FL 3
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1800 ZOLLINGER RD FL 3
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43221-2800
Practice Address - Country:US
Practice Address - Phone:614-293-2130
Practice Address - Fax:614-293-3087
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN67311041C0700X
OHI.19016181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1548611486Medicaid