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General NPI Number Information
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NPI Number | 1689559833
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Entity Type | Individual
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Provider Name | JOHNNY ALLEN
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Gender | Male
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1 TRIANGLE PARK DR
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City | CINCINNATI
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State | OH
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Zip | 45246-3423
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Country | US
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Telephone | 800-411-8019
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 ATLANTIC AVE # SWT400
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8165
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.193291
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License Number State | OH
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