Provider Demographics
NPI:1083085708
Name:VOYNOVICH, IVY RUFINA (MS LCDC III)
Entity Type:Individual
Prefix:MRS
First Name:IVY
Middle Name:RUFINA
Last Name:VOYNOVICH
Suffix:
Gender:F
Credentials:MS LCDC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 GLENCROSSING WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3361
Mailing Address - Country:US
Mailing Address - Phone:513-827-9044
Mailing Address - Fax:513-832-1332
Practice Address - Street 1:5122 GLENCROSSING WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3361
Practice Address - Country:US
Practice Address - Phone:513-827-9044
Practice Address - Fax:513-832-1332
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH081062101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)