Healthcare Provider Details

I. General information

NPI: 1568629400
Provider Name (Legal Business Name): JOSEPH RICHARD LITE LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 WILMINGTON AVE
DAYTON OH
45420-4112
US

IV. Provider business mailing address

1136 WILMINGTON AVE
DAYTON OH
45420-4112
US

V. Phone/Fax

Practice location:
  • Phone: 937-254-6700
  • Fax: 937-254-6776
Mailing address:
  • Phone: 937-254-6700
  • Fax: 937-254-6776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE0001096
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.923343
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: