Provider Demographics
NPI:1558585612
Name:DOWNEY, JAMES (EDD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:DOWNEY
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 NILLES RD STE F1
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-3644
Mailing Address - Country:US
Mailing Address - Phone:513-858-3777
Mailing Address - Fax:513-858-3900
Practice Address - Street 1:780 NILLES RD STE F1
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-3644
Practice Address - Country:US
Practice Address - Phone:513-858-3777
Practice Address - Fax:513-858-3900
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000013919OtherBCBS ID
OH72938OtherCIGNA ID
OH72938OtherCIGNA ID