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General NPI Number Information
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NPI Number | 1376422006
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Entity Type | Organization
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Legal Business Name | GROUNDWORK PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 4965 ABBOT RUN CT
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City | LIBERTY TWP
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State | OH
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Zip | 45011-8656
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Country | US
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Telephone | 513-254-8894
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Fax |
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Provider Business Mailing Address
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Address Line | 4965 ABBOT RUN CT
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City | LIBERTY TWP
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State | OH
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Zip | 45011-8656
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Country | US
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Telephone | 513-254-8894
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AARON DAVID MILLER
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Credential | PH.D.
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Telephone | 513-254-8894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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