Raheem Abdullah
Individual provider Active NPI Peer Specialist · Cincinnati, OH
NPI 1639980477 · NPPES record last updated Jul 12, 2026
Key facts
- NPI
- 1639980477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- PRS.008105 (OH)
- Practice address
- 830 Ezzard Charles Dr
Cincinnati, OH 45214-2525 - Phone
- (513) 381-6672
- NPI assigned
- Jan 20, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modern Psychiatry and Wellness LLC | Current |
Accepting new patients |
Locations
1910 Fairgrove Ave
Ste E
Hamilton, OH 45011
Phone (513) 299-4025
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/mpwhealth/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | PRS.008105 | OH | Yes |
Addresses
Primary practice location
830 Ezzard Charles Dr
Cincinnati, OH 45214-2525
Mailing address
830 Ezzard Charles Dr
Cincinnati, OH 45214-2525
Phone (513) 381-6672
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.