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General NPI Number Information
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NPI Number | 1427608207
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Entity Type | Individual
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Provider Name | PATRICK HENRY MA, MA, LPC, LPCC
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Gender | Male
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 3012 GLENMORE AVE
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City | CINCINNATI
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State | OH
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Zip | 45238-2269
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Country | US
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Telephone | 720-270-7890
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 396
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City | SPRINGBORO
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State | OH
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Zip | 45066-0396
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Country | US
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Telephone | 720-270-7890
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.2303839
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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 | C.1902256
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License Number State | OH
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