Healthcare Provider Details

I. General information

NPI: 1891553384
Provider Name (Legal Business Name): ADRIAN MCMILLAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 MONROE ST STE 2
SYLVANIA OH
43560-2263
US

IV. Provider business mailing address

980 E BOUNDARY ST
PERRYSBURG OH
43551-2406
US

V. Phone/Fax

Practice location:
  • Phone: 419-343-7737
  • Fax:
Mailing address:
  • Phone: 567-377-1515
  • Fax: 419-531-5117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2607991
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: