Healthcare Provider Details

I. General information

NPI: 1760949424
Provider Name (Legal Business Name): DIAMOND R. BRADFORD LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10921 REED HARTMAN HWY STE 133
BLUE ASH OH
45242-2851
US

IV. Provider business mailing address

10921 REED HARTMAN HWY STE 133
BLUE ASH OH
45242-2851
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-9838
  • Fax:
Mailing address:
  • Phone: 513-984-9838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2003021
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2606975
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: