Healthcare Provider Details

I. General information

NPI: 1144747809
Provider Name (Legal Business Name): CHELSEA AMANDA SMITH CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA CABIL

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5108 SANDY LN
FAIRFIELD OH
45014-2738
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 400
CINCINNATI OH
45212-2600
US

V. Phone/Fax

Practice location:
  • Phone: 866-934-7450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.166719
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: