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General NPI Number Information
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NPI Number | 1518629625
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Entity Type | Individual
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Provider Name | MARIAH BROOKE TENDAM LPCC
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Gender | Female
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 8200 BECKETT PARK DR STE 111
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City | WEST CHESTER
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State | OH
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Zip | 45069-9316
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Country | US
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Telephone | 513-991-7007
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Fax |
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Provider Business Mailing Address
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Address Line | 380 N WASHINGTON BLVD
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City | HAMILTON
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State | OH
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Zip | 45013-2338
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Country | US
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Telephone | 513-443-4363
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.2404613
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License Number State | OH
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