Healthcare Provider Details
I. General information
NPI: 1285567982
Provider Name (Legal Business Name): HEROIC SOUL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4450 CARVER WOODS DR STE 1
BLUE ASH OH
45242-5528
US
IV. Provider business mailing address
8773 CONSTANCE LN
CINCINNATI OH
45231-4701
US
V. Phone/Fax
- Phone: 513-279-8321
- Fax:
- Phone: 513-279-8321
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMES
COLMAR
Title or Position: PSYCHOLOGIST
Credential: PSY.D
Phone: 513-279-8321