Healthcare Provider Details

I. General information

NPI: 1255249629
Provider Name (Legal Business Name): CHERRIE BLEVINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 OHIO PIKE STE 102
CINCINNATI OH
45255-3746
US

IV. Provider business mailing address

4260 MOUNT CARMEL TOBASCO RD APT C26
CINCINNATI OH
45244-2352
US

V. Phone/Fax

Practice location:
  • Phone: 513-939-0300
  • Fax:
Mailing address:
  • Phone: 513-488-7161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2406072
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: