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NPI Code Detail

MEDICARE: JUDY L DAUBENMIRE LPCC-S

MEDICARE: JUDY L DAUBENMIRE LPCC-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorE3700OH
2101YP2500XProfessional CounselorE.0003700-SUPVOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043268006
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY L DAUBENMIRE LPCC-S
Provider Business Mailing Address
First Line : 850 BOARDMAN CANFIELD RD
Second Line : SUITE 1
City : BOARDMAN
State : OH
Zip : 44512-4234
Country : US
Telephone Number : 330-770-6269
Fax Number :
Provider Business Practice Location Address
First Line : 45875 BELL SCHOOL RD STE B
Second Line :
City : EAST LIVERPOOL
State : OH
Zip : 43920-8728
Country : US
Telephone Number : 330-397-6007
Fax Number : 234-254-5655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 08/16/2024

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Directions to “ JUDY L DAUBENMIRE LPCC-S” Practice Location

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