MEDICARE: GRETA COLOMBO LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C.2305389	OH

General Provider Information

NPI Number	:	1073375556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRETA COLOMBO LPC

Provider Business Mailing Address
First Line	:	515 E 12TH ST APT 5
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-7446
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5725 DRAGON WAY STE 100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-4519
Country	:	US
Telephone Number	:	513-613-4824
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2024
Last Update Date	:	01/29/2024

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Directions to “ GRETA COLOMBO LPC” Practice Location

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