Provider Demographics
NPI:1487750428
Name:CANFIELD, JAMES J (LISW-S)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:J
Last Name:CANFIELD
Suffix:
Gender:M
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8040 HOSBROOK RD STE 320
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2908
Mailing Address - Country:US
Mailing Address - Phone:513-861-9797
Mailing Address - Fax:513-861-3510
Practice Address - Street 1:8040 HOSBROOK RD STE 320
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2908
Practice Address - Country:US
Practice Address - Phone:513-861-9797
Practice Address - Fax:513-861-3510
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0009369.SUPV1041C0700X, 1041C0700X
OHI 00093691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0074861OtherOHIO DEPT. OF ALCOHOL & DRUG ADDICTION SERVICES (GROUP)
OH0074946OtherOHIO DEPT. OF MENTAL HEALTH (GROUP)
OH01-0693OtherCARF CERTIFIED ACCREDITATION
OHH130910OtherMEDICARE PTAN GROUP ACCESS COUNSELING SERVICES, LLC