MEDICARE: PREMIER MENTAL HEALTH PROFESSIONALS

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1649133703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER MENTAL HEALTH PROFESSIONALS

Provider Business Mailing Address
First Line	:	3380 ERIE AVE STE 100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-1626
Country	:	US
Telephone Number	:	513-400-5124
Fax Number	:

Provider Business Practice Location Address
First Line	:	3380 ERIE AVE STE 100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-1626
Country	:	US
Telephone Number	:	513-400-5124
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST/OWNER
Name	:	PENELOPE CHAVEZ-FRIGON
Credential	:	PSY.D.
Telephone Number	:	513-478-5786

Provider Enumeration Date	:	12/05/2025
Last Update Date	:	05/20/2026

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