Healthcare Provider Details

I. General information

NPI: 1770010704
Provider Name (Legal Business Name): FLOURISH PSYCHOTHERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E COURT ST STE 350
CINCINNATI OH
45202-1201
US

IV. Provider business mailing address

PO BOX 17007
CINCINNATI OH
45217-0007
US

V. Phone/Fax

Practice location:
  • Phone: 513-999-2448
  • Fax:
Mailing address:
  • Phone: 513-999-2448
  • Fax: 855-248-4035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LAUREN SHARP-PAGE
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LPCC-S
Phone: 513-999-2448