Healthcare Provider Details

I. General information

NPI: 1033708680
Provider Name (Legal Business Name): DAVONE HUTCHINSON MSW, CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2021
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 FULTON AVE
CINCINNATI OH
45206-2504
US

IV. Provider business mailing address

975 ENRIGHT AVE UNIT 7026
CINCINNATI OH
45205-7526
US

V. Phone/Fax

Practice location:
  • Phone: 513-961-4663
  • Fax:
Mailing address:
  • Phone: 513-591-8472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.175271
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: