Healthcare Provider Details

I. General information

NPI: 1922571876
Provider Name (Legal Business Name): JENNIFER M GOBEL CT, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 EXECUTIVE PARK DR STE 350
SHARONVILLE OH
45241-4046
US

IV. Provider business mailing address

4000 EXECUTIVE PARK DR STE 350
SHARONVILLE OH
45241-4046
US

V. Phone/Fax

Practice location:
  • Phone: 513-400-4454
  • Fax: 513-978-0144
Mailing address:
  • Phone: 513-400-4454
  • Fax: 513-978-0144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.1801488-TRNE
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1902375
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: