Provider Demographics
NPI:1902545817
Name:GUY, DEREK JERMAINE
Entity Type:Individual
Prefix:MR
First Name:DEREK
Middle Name:JERMAINE
Last Name:GUY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:KELSEA
Other - Middle Name:ANTOINETTE
Other - Last Name:GUY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:415 GLENSPRINGS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-2353
Mailing Address - Country:US
Mailing Address - Phone:513-252-0248
Mailing Address - Fax:
Practice Address - Street 1:415 GLENSPRINGS DR STE 201
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-2353
Practice Address - Country:US
Practice Address - Phone:513-252-0248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator