Provider Demographics
NPI:1922580422
Name:CONRAD-MCPEEK, CAROLYN J (LISW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:J
Last Name:CONRAD-MCPEEK
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 1:3863 HAMILTON SCIPIO RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-9229
Mailing Address - Country:US
Mailing Address - Phone:513-341-6797
Mailing Address - Fax:
Practice Address - Street 1:6 S 2ND ST STE 514
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-2866
Practice Address - Country:US
Practice Address - Phone:513-341-6797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.18021511041C0700X
OHI.22038781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical