Provider Demographics
NPI:1922867357
Name:CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER
Entity Type:Organization
Organization Name:CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPCC- SCHOOL BASED
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:859-940-3257
Mailing Address - Street 1:6370 MASON-MONTGOMERY ROAD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040
Mailing Address - Country:US
Mailing Address - Phone:513-398-9035
Mailing Address - Fax:513-459-0904
Practice Address - Street 1:6370 MASON-MONTGOMERY ROAD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-398-9035
Practice Address - Fax:513-459-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty