=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285567982
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEROIC SOUL JAMES COLMAR SOLE MEMBER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2026
-----------------------------------------------------
Last Update Date | 06/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4450 CARVER WOODS DR STE 1
-----------------------------------------------------
City | BLUE ASH
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45242-5528
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-279-8321
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8773 CONSTANCE LN
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45231-4701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-279-8321
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHOLOGIST
-----------------------------------------------------
Name | DR. JAMES COLMAR
-----------------------------------------------------
Credential | PSY.D
-----------------------------------------------------
Telephone | 513-279-8321
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------