Healthcare Provider Details

I. General information

NPI: 1922650860
Provider Name (Legal Business Name): MARIAH COUSER PHD, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
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
CINCINNATI OH
45241-4046
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1902088
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2102447
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: