MEDICARE: DIANNA GREIVENKAMP LPC

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
1	101YM0800X	Mental Health Counselor	C.2607888	OH

General Provider Information

NPI Number	:	1154021012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANNA GREIVENKAMP LPC

Provider Business Mailing Address
First Line	:	5630 BRIDGETOWN RD STE 4
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-4346
Country	:	US
Telephone Number	:	513-939-0300
Fax Number	:

Provider Business Practice Location Address
First Line	:	4805 KLEEMAN GREEN DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1991
Country	:	US
Telephone Number	:	513-673-5476
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2023
Last Update Date	:	04/21/2026

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