Healthcare Provider Details

I. General information

NPI: 1578428942
Provider Name (Legal Business Name): PHILAUTIA TD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9132 PEACHBLOSSOM CT
CINCINNATI OH
45231-4811
US

IV. Provider business mailing address

9132 PEACHBLOSSOM CT
CINCINNATI OH
45231-4811
US

V. Phone/Fax

Practice location:
  • Phone: 513-824-1948
  • Fax: 513-662-7808
Mailing address:
  • Phone: 513-824-1948
  • Fax: 513-662-7808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
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 TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: TERESA NMN NARED
Title or Position: CEO
Credential:
Phone: 513-824-1948