Provider Demographics
NPI:1679057442
Name:WHITFIELD, ALONZO (QMHS)
Entity Type:Individual
Prefix:
First Name:ALONZO
Middle Name:
Last Name:WHITFIELD
Suffix:
Gender:M
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2374 LOSANTIVILLE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-4445
Mailing Address - Country:US
Mailing Address - Phone:513-658-2024
Mailing Address - Fax:
Practice Address - Street 1:4836 WARD ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-2347
Practice Address - Country:US
Practice Address - Phone:513-658-2024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health