Provider Demographics
NPI:1841022449
Name:VERNON, HALLIE ANNE (LSW)
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:ANNE
Last Name:VERNON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 TOWNE COMMONS WAY APT 31
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-6137
Mailing Address - Country:US
Mailing Address - Phone:440-725-6115
Mailing Address - Fax:
Practice Address - Street 1:2250 PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45015-1135
Practice Address - Country:US
Practice Address - Phone:513-868-1562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2309028104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker