MODERN PSYCHIATRY & WELLNESS, LLC (NPI# 1699251553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699251553 |
| Entity Type | Organization |
| Organization Name | MODERN PSYCHIATRY & WELLNESS, LLC |
| Practice Address |
1910 Fairgrove Ave Ste E Hamilton OH 45011-1930 |
| Practice Telephone | 5137957557 |
| Practice Fax Number | 5137957518 |
| Mailing Telephone | 5137957557 |
| Mailing Fax Number | 5137957518 |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2020-10-27 |
| Authorized Official Name | MS. SUSANNA MARIE LOZANO (C.O.O.) |
| Authorized Official Telephone | 5132994025 |
| Authorized Official Credential | LISW-S, LICDC-CS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0118852 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 621 S Erie Hwy, Hamilton, OH 450114315 | 5137957557 | 5137957518 |
| 6942 Tylersville Rd, West Chester, OH 450691511 | 5138680055 | 5132977577 |
| Street Address |
1910 FAIRGROVE AVE STE E |
| City | HAMILTON |
| State | OH |
| Zip Code | 45011-1930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306993985 | Quinton E Moss | Psychiatry & Neurology | 1910 Fairgrove Ave Ste E, Hamilton, OH 45011-1930 | 2007-01-04 |
| 1609476928 | Sarah Tasseff | Case Manager/Care Coordinator | 1910 Fairgrove Ave Ste E, Hamilton, OH 45011-1930 | 2020-10-27 |
| 1619574944 | John Bohlen | Case Manager/Care Coordinator | 1910 Fairgrove Ave Ste E, Hamilton, OH 45011-1930 | 2020-10-09 |
| 1174177687 | Rachel Plaugher | Counselor | 1910 Fairgrove Ave Ste E, Hamilton, OH 45011-1930 | 2019-08-01 |
| 1730671447 | Lori Ann Kees | Social Worker | 1910 Fairgrove Ave Ste E, Hamilton, OH 45011-1930 | 2018-05-30 |
| 1992293583 | Johnny Bennett | Counselor | 1910 Fairgrove Ave Ste E, Hamilton, OH 45011-1930 | 2018-04-29 |
| 1427592435 | Brice Henry | Counselor | 1910 Fairgrove Ave Ste E, Hamilton, OH 45011-1930 | 2016-12-09 |
| 1225260888 | Modern Psychiatry and Wellness LLC | Clinic/Center | 1910 Fairgrove Ave Ste E, Hamilton, OH 45011-1930 | 2009-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831702000 | Trisha Sue Allen | Case Manager/Care Coordinator | Sojourner Recovery Services, 515 Dayton Street, Hamilton, OH 45011 | 2020-08-27 |
| 1235755158 | Toika Thompson | Community Health Worker | 614 S 4th St, Hamilton, OH 45011 | 2020-06-17 |
| 1912477589 | Bernice Lorene Garrison | Registered Nurse | 621 S. Erie Boulevard, Hamilton, OH 45011 | 2018-11-27 |
| 1811465040 | Delanie Darcelle Kidd | Counselor | 515 High Street, Hamilton, OH 45011 | 2018-11-06 |
| 1386128288 | Matthew Smith | Counselor | 621 E Erie Highway, Hamilton, OH 45011 | 2018-09-18 |
| 1912485863 | Heavens Quest LLC | Home Health | 415 North Erie Blvd, Hamilton, OH 45011 | 2018-08-02 |
| 1326532748 | Margaret Phillips | Nurse Practitioner | 5290 Poets Way, Liberty Twp, OH 45011 | 2018-06-19 |
| 1891284386 | Myles Evan Silas | Counselor | 1210 N W Washington Blvd #4, Hamilton, OH 45011 | 2018-05-09 |
| 1295223436 | Taylor Guecking | Counselor | 621 South Erie Highway, Hamilton, OH 45011 | 2018-04-24 |
| 1790282069 | Leroy Thomas Brown | Counselor | 621 South Erie Blvd, Hamilton, OH 45011 | 2018-04-12 |
| Find all providers in zip 45011 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639228893 | Hhbh | Clinic/Center | 1 Electronics Dr, Hamilton, NJ 08619-2054 | 2007-01-09 |
| 1053955096 | Mind Your Mind | Clinic/Center | 2083 Klockner Rd, Hamilton, NJ 08690-3415 | 2019-11-02 |
| 1972150159 | Vital Signs Consulting Services Inc | Clinic/Center | 1457 Nottingham Way, Hamilton, NJ 08609 | 2019-08-21 |
| 1497128623 | George Stephen Hyatt Gateway Counseling, LLC | Clinic/Center | 20 High St, Ste 119, Hamilton, OH 45011-2709 | 2015-11-10 |
| 1235564360 | Medallion Care Trenton | Clinic/Center | 1 Electronics Dr, Hamilton, NJ 08619-2054 | 2013-09-09 |
| 1225260888 | Modern Psychiatry and Wellness LLC | Clinic/Center | 1910 Fairgrove Ave Ste E, Hamilton, OH 45011-1930 | 2009-08-17 |
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| 1679188536 | Sea Glass Counseling and Consultation, LLC | Clinic/Center | 7757 Amberfalls Ct, Dublin, OH 43016-9041 | 2020-09-08 |
| 1447860903 | Recovery Works LLC | Clinic/Center | 2833 Cleveland Ave Nw, Canton, OH 44709-3203 | 2020-08-08 |
| 1598380453 | Courage To Heal Counseling LLC | Clinic/Center | 304 S Court St Ste A, Circleville, OH 43113-1604 | 2020-06-16 |
| 1477178846 | Small Behavioral Health Counseling | Clinic/Center | 1213 Coventry St, Akron, OH 44306-2229 | 2020-06-11 |
| 1265055693 | Sola Caritas | Clinic/Center | 2967 W 38th St, Cleveland, OH 44113-4803 | 2020-05-20 |
| 1417570946 | Flourish Counseling, LLC | Clinic/Center | 24757 Hawthorne Dr, Beachwood, OH 44122-2317 | 2020-05-19 |
| 1346869682 | 2020 Life Counseling LLC | Clinic/Center | 21724 Lorain Rd Ste 8, Fairview Park, OH 44126-3334 | 2020-04-15 |
| 1306407887 | Freedom Counseling, Coaching, and Consulting, LLC | Clinic/Center | 2174 Kelley Ln, Newark, OH 43055-8057 | 2019-06-25 |
| 1255997599 | Jana Bergfeld Lisw LLC | Clinic/Center | 1071 Fishinger Rd Ste 211, Columbus, OH 43221-2301 | 2019-05-13 |
| 1861056921 | Mobile Physician Services Inc. | Clinic/Center | 4031 Colonel Glenn Hwy Ste 133, Beavercreek Township, OH 45431-2774 | 2019-04-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.