Provider Demographics
NPI:1750731089
Name:ANDERSON, TAMERA N (LISW)
Entity type:Individual
Prefix:
First Name:TAMERA
Middle Name:N
Last Name:ANDERSON
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 1:10999 REED HARTMAN HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-8301
Mailing Address - Country:US
Mailing Address - Phone:513-802-9582
Mailing Address - Fax:513-456-4219
Practice Address - Street 1:8857 CINCINNATI DAYTON RD STE 202
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-3192
Practice Address - Country:US
Practice Address - Phone:513-802-9582
Practice Address - Fax:513-456-4219
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2024-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.18010891041C0700X
OHS-16003391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical