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NPI Code Detail

MEDICARE: COMMUNITY BEHAVIORAL HEALTH, INC.

MEDICARE: COMMUNITY BEHAVIORAL HEALTH, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332900000XNon-Pharmacy Dispensing Site02-13115000OH
2101YA0400XAddiction (Substance Use Disorder) Counselor10993OH
3101YM0800XMental Health Counselor0481OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12846611OTHEROHCROSSOVER

General Provider Information

NPI Number : 1134365745
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY BEHAVIORAL HEALTH, INC.
Provider Business Mailing Address
First Line : 820 S. MARTIN LUTHER KING, JR. BLVD
Second Line :
City : HAMILTON
State : OH
Zip : 45011-3216
Country : US
Telephone Number : 513-887-8500
Fax Number : 513-737-8196
Provider Business Practice Location Address
First Line : 820 S MARTIN LUTHER KING JR BLVD
Second Line :
City : HAMILTON
State : OH
Zip : 45011-3216
Country : US
Telephone Number : 513-887-8500
Fax Number : 513-737-8196
Authorized Official
Title or Position : CFO
Name : MARK ZOELLNER
Credential :
Telephone Number : 513-785-4742
Provider Enumeration Date : 01/02/2009
Last Update Date : 03/10/2020

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