Provider Demographics
NPI:1851044309
Name:NEFF, AUTUMN TAYLOR (CDCA)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:TAYLOR
Last Name:NEFF
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:TAYLOR
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDCAP
Mailing Address - Street 1:4600 MONTGOMERY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:560 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-2331
Practice Address - Country:US
Practice Address - Phone:513-834-7063
Practice Address - Fax:866-460-2997
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.179526101YA0400X
OHCDCA.183471101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)