Healthcare Provider Details

I. General information

NPI: 1356966964
Provider Name (Legal Business Name): LISA HUNT CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3654 WERK RD
CINCINNATI OH
45248-4900
US

IV. Provider business mailing address

6417 MONALISA CT
CINCINNATI OH
45239-5636
US

V. Phone/Fax

Practice location:
  • Phone: 513-549-0417
  • Fax:
Mailing address:
  • Phone: 513-806-0175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: