Healthcare Provider Details

I. General information

NPI: 1710579727
Provider Name (Legal Business Name): VANESSA CHEYANN NEWELL CT, BA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4633 AICHOLTZ RD
CINCINNATI OH
45244-1447
US

IV. Provider business mailing address

4629 AICHOLTZ RD STE 2
CINCINNATI OH
45244-1560
US

V. Phone/Fax

Practice location:
  • Phone: 513-752-1555
  • Fax: 513-688-8155
Mailing address:
  • Phone: 513-752-1555
  • Fax: 513-688-8155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2607651-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: