MEDICARE: BRIAN WILLIAM ALLEN 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDCA.179967	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	:	1679155006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN WILLIAM ALLEN CDCA

Provider Business Mailing Address
First Line	:	6460 HARRISON AVE STE 200
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-7821
Country	:	US
Telephone Number	:	513-941-4999
Fax Number	:	513-941-7555

Provider Business Practice Location Address
First Line	:	1435 CINCINNATI ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-4614
Country	:	US
Telephone Number	:	513-941-4999
Fax Number	:	513-694-0168

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

Provider Enumeration Date	:	04/26/2021
Last Update Date	:	01/15/2026

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