Provider Demographics
NPI:1427246073
Name:DORKO, CASIE GERMAIN (MS, LSW)
Entity type:Individual
Prefix:
First Name:CASIE
Middle Name:GERMAIN
Last Name:DORKO
Suffix:
Gender:F
Credentials:MS, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7112 GRANTHAM WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2213
Mailing Address - Country:US
Mailing Address - Phone:513-258-4103
Mailing Address - Fax:
Practice Address - Street 1:3740 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45205-1354
Practice Address - Country:US
Practice Address - Phone:513-354-5636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0701211104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker