Provider Demographics
NPI:1821267584
Name:CINCINNATI PSYCHIATRIC SERVICES, INC
Entity Type:Organization
Organization Name:CINCINNATI PSYCHIATRIC SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-984-2333
Mailing Address - Street 1:10495 MONTGOMERY RD STE 28
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4420
Mailing Address - Country:US
Mailing Address - Phone:513-984-2333
Mailing Address - Fax:513-984-8333
Practice Address - Street 1:10495 MONTGOMERY RD STE 28
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4420
Practice Address - Country:US
Practice Address - Phone:513-984-2333
Practice Address - Fax:513-984-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350748102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2210717Medicaid
OH2210717Medicaid