MEDICARE: MISS BRITTANEY NICOLE BAINES

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	101YA0400X	Addiction (Substance Use Disorder) Counselor		OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417487109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS BRITTANEY NICOLE BAINES

Provider Business Mailing Address
First Line	:	2222 VINE ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-1828
Country	:	US
Telephone Number	:	513-751-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 VINE ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-1828
Country	:	US
Telephone Number	:	513-751-8600
Fax Number	:

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

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	07/21/2022

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1962759506 — TIFFANI J SURRATT LCDCIII
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2222 VINE ST
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1760802615 — MRS. CAROLYN L GIBSON LSW
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1891147682 — MRS. CAROLYN WORLEY LICDC-CS LISW-S
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1760834998 — ELIZABETH ROESE
Practice Location Address:

2222 VINE ST
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1295284313 — MRS. LINDSAY R KEEBLE LPPC
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1689189755 — JOANNE JONES CDCA
Practice Location Address:

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Directions to “ MISS BRITTANEY NICOLE BAINES ” Practice Location

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