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NPI Code Detail

MEDICARE: MIRANDA HUPP CDCA

MEDICARE: MIRANDA HUPP CDCA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.192826OH

General Provider Information

NPI Number : 1447112008
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA HUPP CDCA
Provider Business Mailing Address
First Line : 4600 MONTGOMERY RD STE 400
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-2600
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2210 S RIDGE RD E
Second Line :
City : ASHTABULA
State : OH
Zip : 44004-4459
Country : US
Telephone Number : 833-510-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 03/09/2026

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Directions to “ MIRANDA HUPP CDCA” Practice Location

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