MEDICARE: DR. CAROLYN VALERIE FLUHART PH.D.

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	103TC0700X	Clinical Psychologist	5324	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5324	OTHER	OH	STATE LICENSE NUMBER
2	000000356759	OTHER	OH	ANTHEM BCBS PIN
3	251496	OTHER	OH	PHCS ID NO.
4	11485229	OTHER	OH	CAQH ID
5	272966000	OTHER	OH	MAGELLAN PROVIDER NO.
6	251496	OTHER	OH	COMPSYCH ID NO.

General Provider Information

NPI Number	:	1891768503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLYN VALERIE FLUHART PH.D.

Provider Business Mailing Address
First Line	:	2903 STATE ROUTE 232
Second Line	:
City	:	BETHEL
State	:	OH
Zip	:	45106-8220
Country	:	US
Telephone Number	:	513-734-1876
Fax Number	:	513-734-1876

Provider Business Practice Location Address
First Line	:	1324 STATE ROUTE 125
Second Line	:	STE 202
City	:	AMELIA
State	:	OH
Zip	:	45102-0015
Country	:	US
Telephone Number	:	513-981-7363
Fax Number	:	513-779-9209

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

Provider Enumeration Date	:	02/12/2006
Last Update Date	:	06/19/2016

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