Healthcare Provider Details

I. General information

NPI: 1275891087
Provider Name (Legal Business Name): MICHAEL K LEMASTER LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 06/09/2020
Certification Date: 06/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 URBANA ROAD SUITE 201
SPRINGFIELD OH
44502
US

IV. Provider business mailing address

4949 URBANA ROAD SUITE 201
SPRINGFIELD OH
44502
US

V. Phone/Fax

Practice location:
  • Phone: 937-390-3800
  • Fax: 937-426-6230
Mailing address:
  • Phone: 937-390-3800
  • Fax: 937-426-6230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC-1100065
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: