Provider Demographics
NPI:1164230314
Name:IVY'S HEALING PATH MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:IVY'S HEALING PATH MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:CIARA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:MERRIWEATHER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC, FNP-C
Authorized Official - Phone:513-675-7203
Mailing Address - Street 1:3152 OXFORD TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-9366
Mailing Address - Country:US
Mailing Address - Phone:513-675-7203
Mailing Address - Fax:
Practice Address - Street 1:3152 OXFORD TRENTON RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-9366
Practice Address - Country:US
Practice Address - Phone:513-675-7203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty