Healthcare Provider Details

I. General information

NPI: 1144093154
Provider Name (Legal Business Name): ANTHONY POWELL CDCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 CENTRAL PKWY
CINCINNATI OH
45214-2355
US

IV. Provider business mailing address

6460 HARRISON AVE STE 200
CINCINNATI OH
45247-7821
US

V. Phone/Fax

Practice location:
  • Phone: 513-941-4999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.191867
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: