Provider Demographics
NPI:1811175912
Name:SETON FAMILY CENTER
Entity type:Organization
Organization Name:SETON FAMILY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HELMUT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROEHRIG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-471-9169
Mailing Address - Street 1:3316 WERK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-6844
Mailing Address - Country:US
Mailing Address - Phone:513-471-9169
Mailing Address - Fax:513-471-9159
Practice Address - Street 1:3316 WERK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-6844
Practice Address - Country:US
Practice Address - Phone:513-471-9169
Practice Address - Fax:513-471-9159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00058851041C0700X
OH5639103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0771795Medicaid
OHSE9245561Medicare PIN