MEDICARE: COUNSELING ALLIANCE, PLLC

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

General Provider Information

NPI Number	:	1174944615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELING ALLIANCE, PLLC

Provider Business Mailing Address
First Line	:	1251 KEMPER MEADOW DR
Second Line	:	SUITE 100
City	:	CINCINNATI
State	:	OH
Zip	:	45240-4121
Country	:	US
Telephone Number	:	513-376-9757
Fax Number	:	513-376-8347

Provider Business Practice Location Address
First Line	:	1251 KEMPER MEADOW DR
Second Line	:	SUITE 100
City	:	CINCINNATI
State	:	OH
Zip	:	45240-4121
Country	:	US
Telephone Number	:	513-376-9757
Fax Number	:	513-376-8347

Authorized Official
Title or Position	:	OWNER
Name	:	MR. TIM BARBER
Credential	:	LPCC-S,CSAT-S,NCC
Telephone Number	:	513-376-9757

Provider Enumeration Date	:	12/31/2013
Last Update Date	:	01/27/2016

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