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NPI Code Detail

MEDICARE: MR. TIY WARREN

MEDICARE: MR. TIY WARREN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP1600XPastoral Counselor
2106S00000XBehavior Technician
3175T00000XPeer Specialist
4171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1205794054
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIY WARREN
Provider Business Mailing Address
First Line : 4595 PADDOCK RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-1131
Country : US
Telephone Number : 513-338-9513
Fax Number :
Provider Business Practice Location Address
First Line : 4595 PADDOCK RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-1131
Country : US
Telephone Number : 513-338-9513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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