Provider Demographics
NPI:1346235298
Name:CONRADI, MARGARET S (ED D)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:S
Last Name:CONRADI
Suffix:
Gender:F
Credentials:ED D
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:SEWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:727 ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1401
Mailing Address - Country:US
Mailing Address - Phone:513-831-0827
Mailing Address - Fax:513-831-1294
Practice Address - Street 1:8595 BEECHMONT AVE
Practice Address - Street 2:#303
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4783
Practice Address - Country:US
Practice Address - Phone:513-474-3605
Practice Address - Fax:513-831-1294
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3174103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000002625OtherANTHEM
OH0509284Medicaid
OH000000002625OtherANTHEM
R71351Medicare UPIN