=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467842799
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SARAH C VON LEHMAN
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/26/2015
-----------------------------------------------------
Last Update Date | 01/26/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9403 KENWOOD RD SUITE D 209
-----------------------------------------------------
City | BLUE ASH
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45242-6895
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-600-4040
-----------------------------------------------------
Fax | 513-794-1083
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9403 KENWOOD RD SUITE D 209
-----------------------------------------------------
City | BLUE ASH
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45242-6895
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-600-4040
-----------------------------------------------------
Fax | 513-794-1083
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MENTAL HEALTH COUNSELOR
-----------------------------------------------------
Name | MS. SARAH C VON LEHMAN
-----------------------------------------------------
Credential | M.ED.; M.A.
-----------------------------------------------------
Telephone | 513-600-4040
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | C1100496
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------