Healthcare Provider Details

I. General information

NPI: 1568381077
Provider Name (Legal Business Name): QUEEN CITY BEHAVIORAL HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 EUCLID AVE STE 819
CLEVELAND OH
44114-3315
US

IV. Provider business mailing address

4004 GEORGETOWN RD
BLUE ASH OH
45236-1013
US

V. Phone/Fax

Practice location:
  • Phone: 202-800-5887
  • Fax:
Mailing address:
  • Phone: 202-800-5887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: TREANA PEAVY
Title or Position: CEO/OWNER
Credential: APRN.CNP, PMHNP-BC
Phone: 202-800-5887