Healthcare Provider Details
I. General information
NPI: 1174320840
Provider Name (Legal Business Name): RUTH KESSEH CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/28/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3650 MUDDY CREEK RD STE 100
CINCINNATI OH
45238-2058
US
IV. Provider business mailing address
7373 DAYTON SPRINGFIELD RD
ENON OH
45323-1462
US
V. Phone/Fax
- Phone: 513-347-0375
- Fax:
- Phone: 937-862-0008
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | CDCA.191237 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: