MEDICARE: MARTINA GOODEN

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	175T00000X	Peer Specialist	YPS.000071	OH

General Provider Information

NPI Number	:	1588536924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTINA GOODEN

Provider Business Mailing Address
First Line	:	1501 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206
Country	:	US
Telephone Number	:	513-354-5200
Fax Number	:	513-354-7115

Provider Business Practice Location Address
First Line	:	1501 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206
Country	:	US
Telephone Number	:	513-354-5200
Fax Number	:	513-354-7115

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

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	03/04/2026

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Directions to “ MARTINA GOODEN ” Practice Location

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