Healthcare Provider Details

I. General information

NPI: 1184429466
Provider Name (Legal Business Name): NORDYKE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8044 MONTGOMERY RD STE 700
CINCINNATI OH
45236-2926
US

IV. Provider business mailing address

8107 WOODCREEK DR
FLORENCE KY
41042-9595
US

V. Phone/Fax

Practice location:
  • Phone: 513-440-3866
  • Fax:
Mailing address:
  • Phone: 859-380-9191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY NORDYKE
Title or Position: CEO
Credential:
Phone: 513-623-8422