Healthcare Provider Details

I. General information

NPI: 1275464232
Provider Name (Legal Business Name): THERAPY HAUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 WILLIAM HOWARD TAFT RD APT 912
CINCINNATI OH
45206-1851
US

IV. Provider business mailing address

1815 WILLIAM HOWARD TAFT RD APT 912
CINCINNATI OH
45206-1851
US

V. Phone/Fax

Practice location:
  • Phone: 513-204-9710
  • Fax:
Mailing address:
  • Phone: 513-204-9710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: REZA SHUMAKH
Title or Position: OWNER/ AUTHORIZED OFFICIAL
Credential: LISW-S
Phone: 513-204-9710