Healthcare Provider Details

I. General information

NPI: 1821931783
Provider Name (Legal Business Name): MRS. CHARLENE DANIELLE COLBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 MICKEY AVE
CINCINNATI OH
45204-1629
US

IV. Provider business mailing address

3015 MICKEY AVE
CINCINNATI OH
45204-1629
US

V. Phone/Fax

Practice location:
  • Phone: 513-349-7456
  • Fax: 513-349-7456
Mailing address:
  • Phone: 513-349-7456
  • Fax: 513-349-7456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: