Healthcare Provider Details

I. General information

NPI: 1689538944
Provider Name (Legal Business Name): RABIYR HANIFAH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4595 PADDOCK RD
CINCINNATI OH
45229-1131
US

IV. Provider business mailing address

4595 PADDOCK RD
CINCINNATI OH
45229-1131
US

V. Phone/Fax

Practice location:
  • Phone: 323-270-2165
  • Fax:
Mailing address:
  • Phone: 323-270-2165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: