Provider Demographics
NPI:1649388117
Name:MANHEIM, DEBORAH (LISW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:MANHEIM
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201NW WASHINGTON BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013
Mailing Address - Country:US
Mailing Address - Phone:513-869-7000
Mailing Address - Fax:513-785-4272
Practice Address - Street 1:2201NW WASHINGTON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013
Practice Address - Country:US
Practice Address - Phone:513-869-7000
Practice Address - Fax:513-785-4272
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0009927104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASW27312Medicare ID - Type Unspecified