MEDICARE: STEPHEN B HEILMAN COUNSELING RESOURCE ASSOCIATES

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	103T00000X	Psychologist	3131	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10661	OTHER		MEDICARE HECP

General Provider Information

NPI Number	:	1710164926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN B HEILMAN COUNSELING RESOURCE ASSOCIATES

Provider Business Mailing Address
First Line	:	9900 CINCINNATI COLUMBUS RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45241-1209
Country	:	US
Telephone Number	:	513-779-9955
Fax Number	:	513-779-9955

Provider Business Practice Location Address
First Line	:	9900 CINCINNATI COLUMBUS RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45241-1209
Country	:	US
Telephone Number	:	513-779-9955
Fax Number	:	513-779-9955

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. STEPHEN BERNARD HEILMAN
Credential	:	ED D PSYCHOLOGY
Telephone Number	:	513-779-9955

Provider Enumeration Date	:	01/30/2008
Last Update Date	:	07/12/2024

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