Provider Demographics
NPI:1962900134
Name:MORTON, EMILEY (LISW)
Entity type:Individual
Prefix:
First Name:EMILEY
Middle Name:
Last Name:MORTON
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4790 RED BANK RD STE 126
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1598
Mailing Address - Country:US
Mailing Address - Phone:513-900-2016
Mailing Address - Fax:
Practice Address - Street 1:4790 RED BANK RD STE 126
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1598
Practice Address - Country:US
Practice Address - Phone:513-900-2016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.18009261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2919604Medicaid