| Lswhb Llc | |
|
675 Hobby Horse Ln Milford OH 45150-1461 | |
| (513) 443-1700 | |
| (855) 919-6229 |
| Full Name | Lswhb Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 675 Hobby Horse Ln, Milford, Ohio |
| Authorized Official Name and Position | Newell Del Crane (PRESIDENT) |
| Authorized Official Contact | 5134049932 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lswhb Llc 675 Hobby Horse Ln Milford OH 45150-1461 Ph: (513) 443-1700 | Lswhb Llc 675 Hobby Horse Ln Milford OH 45150-1461 Ph: (513) 443-1700 |
| NPI Number | 1407325939 |
|---|---|
| Provider Enumeration Date | 11/14/2018 |
| Last Update Date | 02/24/2022 |
| Certification Date | 02/24/2022 |
| Medicare PECOS PAC ID | 9638414204 |
|---|---|
| Medicare Enrollment ID | O20181231001294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407325939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Primary |
| Provider Name | Linda Kimble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962602573 PECOS PAC ID: 1658422449 Enrollment ID: I20090708000414 |
| Provider Name | Tia Denise Carrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982135943 PECOS PAC ID: 7618235300 Enrollment ID: I20180102000998 |
| Provider Name | Kristin Holder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841708021 PECOS PAC ID: 7315282191 Enrollment ID: I20181226000619 |
| Provider Name | Kelly Severhof |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245657410 PECOS PAC ID: 9436560802 Enrollment ID: I20201117000634 |
| Provider Name | Erin Brooke Hlad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396079661 PECOS PAC ID: 5294126595 Enrollment ID: I20220404002449 |
| Provider Name | Sharon Beth Grimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215428669 PECOS PAC ID: 4284025685 Enrollment ID: I20221014002788 |
| Provider Name | Sharon Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013090026 PECOS PAC ID: 3072641042 Enrollment ID: I20230622002516 |
| Provider Name | Amanda Emily Athey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992230064 PECOS PAC ID: 1153768916 Enrollment ID: I20240328001991 |
| Provider Name | Jami Erica Bregenzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285280479 PECOS PAC ID: 5799211504 Enrollment ID: I20241203004436 |
| Provider Name | Frankie Madison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811744949 PECOS PAC ID: 1557881455 Enrollment ID: I20250221003098 |
| Provider Name | Jenna Nicole Bernhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598577603 PECOS PAC ID: 1153845623 Enrollment ID: I20250404003127 |
| Provider Name | Tiffany Renee Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760724215 PECOS PAC ID: 0840716288 Enrollment ID: I20250429000578 |
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