Provider Demographics
NPI:1053430637
Name:RASCH, MARCIA ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:ANN
Last Name:RASCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:MARCIA
Other - Middle Name:RASCH
Other - Last Name:POTTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:424 WARDS CORNER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6966
Mailing Address - Country:US
Mailing Address - Phone:513-576-7700
Mailing Address - Fax:513-576-1020
Practice Address - Street 1:100 RIVER VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:OH
Practice Address - Zip Code:45157-8566
Practice Address - Country:US
Practice Address - Phone:513-553-3114
Practice Address - Fax:513-553-1032
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4953103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0251913Medicaid