Healthcare Provider Details

I. General information

NPI: 1164116141
Provider Name (Legal Business Name): EMILY A SWEENEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY VANCE

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 MADISON RD
CINCINNATI OH
45206
US

IV. Provider business mailing address

1501 MADISON RD
CINCINNATI OH
45206
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-5200
  • Fax:
Mailing address:
  • Phone: 513-354-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2506956
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: