Healthcare Provider Details

I. General information

NPI: 1912849001
Provider Name (Legal Business Name): MISTY DASUQI MED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10925 REED HARTMAN HWY STE 300
BLUE ASH OH
45242-2842
US

IV. Provider business mailing address

6300 OLD US ROUTE 33 UNIT B
ATHENS OH
45701-8624
US

V. Phone/Fax

Practice location:
  • Phone: 614-286-3181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2607958
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: