Integrated Interdisciplinary Clinical Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1440413 Issued in OH

Legal business name

INTEGRATED INTERDISCIPLINARY CLINICAL SERVICES, LLC

Practice address

3481 S Dixie Hwy 162
Franklin, OH 45005

Phone

(513) 678-7827

NPI assigned

Jul 17, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Latania Thomas, MPA, MSW, LISW, ACHE

Title

C.E.O and Executive Director

Phone

(513) 678-7827

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1992189088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3481 S DIXIE HWY 162",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "45005",
            "telephone_number": "513-678-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3481 S DIXIE HWY 162",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "45005",
            "telephone_number": "513-678-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED INTERDISCIPLINARY CLINICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "LATANIA",
        "authorized_official_title_or_position": "C.E.O AND EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "513-678-7827",
        "authorized_official_credential": "MPA, MSW, LISW, ACHE"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1440413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.