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General NPI Number Information
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NPI Number | 1881137172
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Entity Type | Individual
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Provider Name | CHASE MAUGER
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Gender | Male
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 2700 VICTORY PARKWAY
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City | CINCINNATI
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State | OH
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Zip | 45206
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Country | US
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Telephone | 513-818-2686
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Fax |
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Provider Business Mailing Address
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Address Line | 8345 BOBOLINK AVE
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City | CINCINNATI
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State | OH
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Zip | 45231-5503
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Country | US
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Telephone |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E.2102599
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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 | C1500525
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License Number State | OH
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