Provider Demographics
NPI:1205903580
Name:GERIG, JONELL (MSW LISW)
Entity type:Individual
Prefix:MS
First Name:JONELL
Middle Name:
Last Name:GERIG
Suffix:
Gender:F
Credentials:MSW LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 NIMITZVIEW DRIVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230
Mailing Address - Country:US
Mailing Address - Phone:513-233-0020
Mailing Address - Fax:513-233-0499
Practice Address - Street 1:1060 NIMITZVIEW DRIVE
Practice Address - Street 2:SUITE 215
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230
Practice Address - Country:US
Practice Address - Phone:513-233-0020
Practice Address - Fax:513-233-0499
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH100034271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH20241529300OtherBWC
GESW28501Medicare ID - Type Unspecified