Healthcare Provider Details

I. General information

NPI: 1114805967
Provider Name (Legal Business Name): JAMI HANEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7593 TYLERS PLACE BLVD
WEST CHESTER OH
45069-6308
US

IV. Provider business mailing address

714 10TH AVE
MIDDLETOWN OH
45044-5571
US

V. Phone/Fax

Practice location:
  • Phone: 513-714-3400
  • Fax:
Mailing address:
  • Phone: 937-732-2365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCAPRE.196374
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: