Healthcare Provider Details

I. General information

NPI: 1174903306
Provider Name (Legal Business Name): JENNIFER SHEARD-LYNCH LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2015
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 GLENSPRINGS DR STE 301
CINCINNATI OH
45246-2354
US

IV. Provider business mailing address

415 GLENSPRINGS DR STE 301
CINCINNATI OH
45246-2354
US

V. Phone/Fax

Practice location:
  • Phone: 513-570-4068
  • Fax: 513-672-1028
Mailing address:
  • Phone: 513-570-4068
  • Fax: 513-672-1028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1700166
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: