Healthcare Provider Details

I. General information

NPI: 1760838742
Provider Name (Legal Business Name): ALLISON MERCER CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 WILLIAM HOWARD TAFT RD
CINCINNATI OH
45219-2103
US

IV. Provider business mailing address

3234 BUELL ST
CINCINNATI OH
45211-6408
US

V. Phone/Fax

Practice location:
  • Phone: 513-616-8774
  • Fax: 513-861-0105
Mailing address:
  • Phone: 513-263-0367
  • Fax: 513-861-0105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number140008
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: