Codi Scott Diamond

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Rockholds, KY

NPI 1295545960 · NPPES record last updated Jan 13, 2025

Key facts

NPI
1295545960
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
191174 (OH)
Practice address
2128 Ky 1418
Rockholds, KY 40759-7605
Phone
(606) 627-8608
NPI assigned
Jan 13, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
191174OHMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 191174 OH Yes

Addresses

Primary practice location

2128 Ky 1418
Rockholds, KY 40759-7605

Mailing address

2128 Ky 1418
Rockholds, KY 40759-7605
Phone (606) 627-8608

Other providers in Rockholds, KY

All providers in Rockholds, KY · Addiction (Substance Use Disorder) Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.