Healthcare Provider Details

I. General information

NPI: 1154554905
Provider Name (Legal Business Name): STEPHEN WARREN PRICE LICDC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 08/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 CONGRESS AVE SUITE B
CINCINNATI OH
45246-4484
US

IV. Provider business mailing address

85 WILLIAMSBURG LN
SHARONVILLE OH
45241-1455
US

V. Phone/Fax

Practice location:
  • Phone: 513-858-2000
  • Fax: 513-858-2888
Mailing address:
  • Phone: 513-858-2000
  • Fax: 513-858-2888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number943972
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: