Provider Demographics
NPI:1902567886
Name:BARNETT, MONTE (CDCA PENDING)
Entity type:Individual
Prefix:
First Name:MONTE
Middle Name:
Last Name:BARNETT
Suffix:
Gender:M
Credentials:CDCA PENDING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4740 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-1893
Mailing Address - Country:US
Mailing Address - Phone:513-667-3654
Mailing Address - Fax:
Practice Address - Street 1:4738 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45226-1893
Practice Address - Country:US
Practice Address - Phone:513-667-3654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.182786101YA0400X
OHAPS.003756175T00000X
251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist