Provider Demographics
NPI:1427119775
Name:NECCO, LLC
Entity type:Organization
Organization Name:NECCO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTRACTS AND LICENSING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:513-440-5791
Mailing Address - Street 1:1404 RACE ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-7297
Mailing Address - Country:US
Mailing Address - Phone:859-991-2846
Mailing Address - Fax:859-276-0864
Practice Address - Street 1:135 MERCHANT ST STE 101
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-3735
Practice Address - Country:US
Practice Address - Phone:513-771-9600
Practice Address - Fax:513-771-2546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 101YP2500X, 253Z00000X, 261QM0801X, 251B00000X
WV3810001251251B00000X
OH01-7558251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100266230Medicaid
OH0181965Medicaid
WV3810001251Medicaid
KY7100294510Medicaid