Healthcare Provider Details

I. General information

NPI: 1275192536
Provider Name (Legal Business Name): AUBRIANNA YVONNE GREENWALT LCDCIII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AUBRIANNA YVONNE KNIGHT

II. Dates (important events)

Enumeration Date: 06/11/2019
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 E 2ND ST
CHILLICOTHEE OH
45601-2593
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 400
CINCINNATI OH
45212-2600
US

V. Phone/Fax

Practice location:
  • Phone: 833-510-4357
  • Fax:
Mailing address:
  • Phone: 833-510-4357
  • Fax: 866-460-2997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCDCIII.162907
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: