Healthcare Provider Details

I. General information

NPI: 1336931294
Provider Name (Legal Business Name): BRANDY TODD CDCA, PRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8608 BLUE ASH RD
CINCINNATI OH
45242-7804
US

IV. Provider business mailing address

1850 CHASE AVE # B6
CINCINNATI OH
45223-1928
US

V. Phone/Fax

Practice location:
  • Phone: 513-356-0312
  • Fax:
Mailing address:
  • Phone: 513-214-7644
  • Fax: 513-214-7644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number192480
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: