Provider Demographics
NPI:1821542093
Name:BILBY, JEREMY
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:BILBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8115 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-4406
Mailing Address - Country:US
Mailing Address - Phone:513-693-9807
Mailing Address - Fax:513-388-0254
Practice Address - Street 1:8595 BEECHMONT AVE STE 310
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-5109
Practice Address - Country:US
Practice Address - Phone:513-693-9807
Practice Address - Fax:513-388-0254
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-095561041C0700X
OHI.21025601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical