Individual ProviderChardonnae LasterSocial WorkerBehavioral Health & Social Service ProvidersPractice Address4633 Aicholtz Rd, Cincinnati, OH 45244-1447(513) 752-1555PECOS EnrollmentBased on the most recent information from CMS, provider Chardonnae Laster does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1104441047Provider TypeIndividualFull NameLaster, ChardonnaeCredentialMSW, LSWGenderFemaleSole ProprietorNoEnumeration Date6/16/2020Last Updated6/16/2020Contact InformationPractice LocationPractice Address4633 Aicholtz Rd, Cincinnati, OH 45244-1447Phone(513) 752-1555FaxUnlisted FaxMailing LocationMailing Address4629 Aicholtz Rd, Cincinnati, OH 45244-1551Phone(513) 752-1555FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseS.2004788Ohio