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NPI Code Detail

MEDICARE: TARA PLYMESSER CDCA

MEDICARE: TARA PLYMESSER 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
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.187688OH

General Provider Information

NPI Number : 1609522010
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA PLYMESSER CDCA
Provider Business Mailing Address
First Line : 2600 VICTORY PKWY
Second Line :
City : CINCINNATI
State : OH
Zip : 45206-1395
Country : US
Telephone Number : 513-751-7747
Fax Number :
Provider Business Practice Location Address
First Line : 709 N HIGH ST
Second Line :
City : MOUNT ORAB
State : OH
Zip : 45154-6501
Country : US
Telephone Number : 513-751-7747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2022
Last Update Date : 04/23/2025

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Directions to “ TARA PLYMESSER CDCA” Practice Location

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