Individual ProviderSamantha MicklerSocial WorkerBehavioral Health & Social Service ProvidersPractice Address555 Cincinnati Batavia Pike, Cincinnati, OH 45244-1557(513) 752-1555PECOS EnrollmentBased on the most recent information from CMS, provider Samantha Mickler 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 ID1811496748Provider TypeIndividualFull NameMickler, SamanthaGenderFemaleSole ProprietorNoEnumeration Date2/6/2018Last Updated7/25/2019Contact InformationPractice LocationPractice Address555 Cincinnati Batavia Pike, Cincinnati, OH 45244-1557Phone(513) 752-1555FaxUnlisted FaxMailing LocationMailing Address555 Cincinnati Batavia Pike, Cincinnati, OH 45244-1557PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseS.1701069Ohio