Healthcare Provider Details

I. General information

NPI: 1598278780
Provider Name (Legal Business Name): VICTORIA M CIPRIANI CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2017
Last Update Date: 09/10/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5241 MONTGOMERY ROAD
CINCINNATI OH
45212-1655
US

IV. Provider business mailing address

5241 MONTGOMERY ROAD
CINCINNATI OH
45212-1655
US

V. Phone/Fax

Practice location:
  • Phone: 513-993-5241
  • Fax:
Mailing address:
  • Phone: 513-993-5241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.161823
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2004756
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberS.2004756
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: