Healthcare Provider Details

I. General information

NPI: 1568625911
Provider Name (Legal Business Name): MICHAEL POINDEXTER LPCC, LICDC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9641 WATERFORD PL APT 205
LOVELAND OH
45140-6233
US

IV. Provider business mailing address

9641 WATERFORD PL APT 205
LOVELAND OH
45140-6233
US

V. Phone/Fax

Practice location:
  • Phone: 513-239-3950
  • Fax:
Mailing address:
  • Phone: 513-239-3950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.0004120
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: