Healthcare Provider Details

I. General information

NPI: 1699956243
Provider Name (Legal Business Name): TIA WEBB LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2007
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 N DETROIT ST
XENIA OH
45385-1960
US

IV. Provider business mailing address

4552 OLDE PARK DR
TIPP CITY OH
45371-9194
US

V. Phone/Fax

Practice location:
  • Phone: 866-534-2639
  • Fax: 800-480-7578
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2009032584
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2607337
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: