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General NPI Number Information
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NPI Number | 1073848750
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Entity Type | Individual
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Provider Name | JERALYN RENEE THARP LPCC-S LICDC
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Gender | Female
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Dates
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Enumeration Date | 10/13/2009
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 8139 OLD TROY PIKE # 1031
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-1067
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Country | US
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Telephone | 937-712-5893
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Fax | 937-962-6210
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Provider Business Mailing Address
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Address Line | 8139 OLD TROY PIKE # 1031
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-1067
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Country | US
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Telephone | 937-712-5893
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Fax | 937-962-6210
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.1800797
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.1800797
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License Number State | OH
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