| Tailor Made Therapeutic Services Llc | |
|
312 Sharon Ct Middletown OH 45042-4947 | |
| (513) 433-4388 | |
| (513) 217-1161 |
| Full Name | Tailor Made Therapeutic Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 312 Sharon Ct, Middletown, Ohio |
| Authorized Official Name and Position | Tia Monique Hale (OWNER) |
| Authorized Official Contact | 5134334388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tailor Made Therapeutic Services Llc 312 Sharon Ct Middletown OH 45042-4947 Ph: (513) 433-4388 | Tailor Made Therapeutic Services Llc 312 Sharon Ct Middletown OH 45042-4947 Ph: (513) 433-4388 |
| NPI Number | 1376235762 |
|---|---|
| Provider Enumeration Date | 05/23/2023 |
| Last Update Date | 05/26/2023 |
| Certification Date | 05/26/2023 |
| Medicare PECOS PAC ID | 8325497381 |
|---|---|
| Medicare Enrollment ID | O20231215001793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376235762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tia M Hale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114470242 PECOS PAC ID: 9234465550 Enrollment ID: I20190724003425 |
| Provider Name | Keshawna Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164190062 PECOS PAC ID: 9739602392 Enrollment ID: I20250325002020 |
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