Healthcare Provider Details
I. General information
NPI: 1003125816
Provider Name (Legal Business Name): CLERMONT COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2010
Last Update Date: 08/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
43 E MAIN ST
AMELIA OH
45102-1993
US
IV. Provider business mailing address
43 E MAIN ST
AMELIA OH
45102-1993
US
V. Phone/Fax
- Phone: 513-947-7000
- Fax: 513-947-7222
- Phone: 513-947-7000
- Fax: 513-947-7222
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
J
O'NEIL
Title or Position: CEO
Credential:
Phone: 513-354-5200