Provider Demographics
NPI:1790359677
Name:BEEL, ALISA (LSW)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:BEEL
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 1:11156 CANAL RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-5815
Mailing Address - Country:US
Mailing Address - Phone:513-772-6166
Mailing Address - Fax:
Practice Address - Street 1:5900 W CHESTER RD STE C
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2951
Practice Address - Country:US
Practice Address - Phone:513-777-2428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS20050761041C0700X
OHS.2005076104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical