Provider Demographics
NPI:1629195276
Name:SIEGFRIED, KAREN GEARS (MSW, LISW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:GEARS
Last Name:SIEGFRIED
Suffix:
Gender:F
Credentials:MSW, LISW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3549 PAPE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1722
Mailing Address - Country:US
Mailing Address - Phone:513-871-6342
Mailing Address - Fax:513-871-4190
Practice Address - Street 1:3726 ISABELLA AVE
Practice Address - Street 2:ISABELLA SUITES A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-2302
Practice Address - Country:US
Practice Address - Phone:513-379-0214
Practice Address - Fax:513-871-4190
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-OOO38361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI-OOO3836OtherLISW