Healthcare Provider Details

I. General information

NPI: 1629553425
Provider Name (Legal Business Name): JAMES ALEXANDER ANDUJAR LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4653 E MAIN ST
WHITEHALL OH
43213-3298
US

IV. Provider business mailing address

4653 E MAIN ST
WHITEHALL OH
43213-3298
US

V. Phone/Fax

Practice location:
  • Phone: 614-384-7798
  • Fax:
Mailing address:
  • Phone: 614-384-7798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2303544
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: