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2181 Victory Pkwy 2nd Floor Cincinnati OH 45206-2901 | |
| (513) 241-2123 | |
| (513) 241-0417 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2181 Victory Pkwy 2nd Floor, Cincinnati, Ohio |
| Authorized Official Name and Position | Gearline Monhollen (OWNER) |
| Authorized Official Contact | 8595251459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2181 Victory Parkway 2nd Floor Cincinnati OH 45206-2906 Ph: (513) 241-2123 | 2181 Victory Pkwy 2nd Floor Cincinnati OH 45206-2901 Ph: (513) 241-2123 |
| NPI Number | 1982235636 |
|---|---|
| Provider Enumeration Date | 01/31/2020 |
| Last Update Date | 03/09/2023 |
| Certification Date | 03/09/2023 |
| Medicare PECOS PAC ID | 9133550627 |
|---|---|
| Medicare Enrollment ID | O20200518001280 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982235636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Michael A Gureasko |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467537985 PECOS PAC ID: 6305993387 Enrollment ID: I20090408000415 |
| Provider Name | Jeffrey Craven |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104821206 PECOS PAC ID: 9234286816 Enrollment ID: I20090420000008 |
| Provider Name | Georgia Adwoa Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265985659 PECOS PAC ID: 7416236864 Enrollment ID: I20180430001660 |
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