Provider Demographics
NPI:1447550835
Name:EATON, CORINNE SMALFELT (LISW)
Entity type:Individual
Prefix:MS
First Name:CORINNE
Middle Name:SMALFELT
Last Name:EATON
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 1:3268 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-2220
Mailing Address - Country:US
Mailing Address - Phone:513-580-4434
Mailing Address - Fax:513-672-1049
Practice Address - Street 1:3268 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2220
Practice Address - Country:US
Practice Address - Phone:513-580-4434
Practice Address - Fax:513-672-1049
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 12015011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical