Healthcare Provider Details

I. General information

NPI: 1013874759
Provider Name (Legal Business Name): SAVANNAH SHIVELEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 ASHLAND AVE
CINCINNATI OH
45206-2204
US

IV. Provider business mailing address

4321 GEORGIA CT APT 2
CINCINNATI OH
45223-1559
US

V. Phone/Fax

Practice location:
  • Phone: 513-767-8886
  • Fax:
Mailing address:
  • Phone: 937-213-2665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number257863
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS.2207411
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: