Provider Demographics
NPI:1760448377
Name:EBERLEIN, LANI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LANI
Middle Name:
Last Name:EBERLEIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10921 REED HARTMAN HWY
Mailing Address - Street 2:SUITE 133
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2830
Mailing Address - Country:US
Mailing Address - Phone:513-984-9838
Mailing Address - Fax:513-984-8075
Practice Address - Street 1:10921 REED HARTMAN HWY
Practice Address - Street 2:SUITE 133
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-2830
Practice Address - Country:US
Practice Address - Phone:513-984-9838
Practice Address - Fax:513-984-8075
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3291103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP16844Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER