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Individual

MR. ANTWON E ELIJAH I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
QMHS/CMS

Contact information

Practice address
813 TROY ST, DAYTON, OH 45404-1852
(937) 982-1500
Mailing address
813 TROY ST, DAYTON, OH 45404-1852
(937) 982-1500

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
104100000X
Social Worker
1041C0700X
Clinical Social Worker
S.1800373-TRNE
OH
171M00000X
Case Manager/Care Coordinator
Primary
OH

Other

Enumeration date
10/10/2018
Last updated
02/13/2026
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