Provider Demographics
NPI:1376901884
Name:HENRY, PARIS (BS, CDCA)
Entity Type:Individual
Prefix:
First Name:PARIS
Middle Name:
Last Name:HENRY
Suffix:
Gender:F
Credentials:BS, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-4611
Mailing Address - Country:US
Mailing Address - Phone:513-629-2300
Mailing Address - Fax:
Practice Address - Street 1:1617 READING RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1413
Practice Address - Country:US
Practice Address - Phone:513-629-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)