Healthcare Provider Details

I. General information

NPI: 1770901571
Provider Name (Legal Business Name): GREGORY HANDLETON MA, LPCC - S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 11/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 CINCINNATI BATAVIA PIKE
CINCINNATI OH
45244-1557
US

IV. Provider business mailing address

551 CINCINNATI BATAVIA PIKE
CINCINNATI OH
45244-1518
US

V. Phone/Fax

Practice location:
  • Phone: 513-752-1555
  • Fax: 513-688-8155
Mailing address:
  • Phone: 513-752-1555
  • Fax: 513-688-8155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0003015
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: