Healthcare Provider Details

I. General information

NPI: 1043142623
Provider Name (Legal Business Name): AMBER MICHELLE GARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 EVANS ST STE 104
CINCINNATI OH
45204-2075
US

IV. Provider business mailing address

801 EVANS ST STE 104
CINCINNATI OH
45204-2075
US

V. Phone/Fax

Practice location:
  • Phone: 513-790-3033
  • Fax: 513-279-3161
Mailing address:
  • Phone: 513-790-3033
  • Fax: 513-279-3136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCAPRE.196198
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: