Provider Demographics
NPI:1679505317
Name:TURCOTT, LISA (LSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:TURCOTT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 BURNET AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2426
Mailing Address - Country:US
Mailing Address - Phone:513-709-0966
Mailing Address - Fax:
Practice Address - Street 1:2825 BURNET AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2426
Practice Address - Country:US
Practice Address - Phone:513-558-9006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2207638104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS.2207638OtherLSW
KY184607OtherMEDICARE GROUP NUMBER