Individual
JONATHAN RANDALL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1526 WITTLOU AVE, CINCINNATI, OH 45224-2155
(513) 808-2229
Mailing address
1526 WITTLOU AVE, CINCINNATI, OH 45224-2155
(513) 808-2229
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
196082
OH
175T00000X
Peer Specialist
Primary
APS.007350
OH
Other
Enumeration date
01/13/2026
Last updated
05/14/2026
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