Healthcare Provider Details

I. General information

NPI: 1497644298
Provider Name (Legal Business Name): REACH ONE CLINICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2025
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 FOREST AVE
CINCINNATI OH
45229-2516
US

IV. Provider business mailing address

434 FOREST AVE
CINCINNATI OH
45229-2516
US

V. Phone/Fax

Practice location:
  • Phone: 513-518-5596
  • Fax:
Mailing address:
  • Phone: 513-518-5596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL COLLINS
Title or Position: PRESIDENT
Credential: LPCC
Phone: 513-518-5596