MEDICARE: CHELSEA AMANDA SMITH CDCA

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
1	171M00000X	Case Manager/Care Coordinator
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDCA.166719	OH

General Provider Information

NPI Number	:	1144747809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA AMANDA SMITH CDCA

Provider Business Mailing Address
First Line	:	4600 MONTGOMERY RD STE 400
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-2600
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5108 SANDY LN
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-2738
Country	:	US
Telephone Number	:	866-934-7450
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2017
Last Update Date	:	02/03/2026

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