Healthcare Provider Details

I. General information

NPI: 1275470429
Provider Name (Legal Business Name): ABDUL MAGBA-KAMARA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 NORTHLAND BLVD STE 113
CINCINNATI OH
45246-3629
US

IV. Provider business mailing address

9575 STATELAND CT
CINCINNATI OH
45251-2392
US

V. Phone/Fax

Practice location:
  • Phone: 513-954-9250
  • Fax:
Mailing address:
  • Phone: 513-954-9250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCAPRE.195809
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: