Healthcare Provider Details

I. General information

NPI: 1669629051
Provider Name (Legal Business Name): JOSHUA A ELLIOTT LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9891 MONTGOMERY RD # 186
MONTGOMERY OH
45242-6424
US

IV. Provider business mailing address

9891 MONTGOMERY RD # 186
MONTGOMERY OH
45242-6424
US

V. Phone/Fax

Practice location:
  • Phone: 513-434-6904
  • Fax: 513-905-4311
Mailing address:
  • Phone: 513-434-6904
  • Fax: 513-905-4311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number164143
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number164143
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2505622
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: