Healthcare Provider Details
I. General information
NPI: 1275665986
Provider Name (Legal Business Name): PEG M MEIS LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/09/2007
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1251 NILLES RD, SUITE 5 COMPAAA POINT COUNSELING SERVICES
CINCINNATI OH
45014
US
IV. Provider business mailing address
733 SOUTHMEADOW CIR
CINCINNATI OH
45231-6096
US
V. Phone/Fax
- Phone: 513-939-0300
- Fax: 513-939-0310
- Phone: 513-560-7157
- Fax: 513-521-5009
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | E2281 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: