MEDICARE: ERIK B BUSKARD LPCC

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	101YP2500X	Professional Counselor	C.1500458	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	C.1500458	OTHER	OH	STATE OF OHIO BOARD OF COUNSELING AND SOCIAL WORK

General Provider Information

NPI Number	:	1790229086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIK B BUSKARD LPCC

Provider Business Mailing Address
First Line	:	PO BOX 933421
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0039
Country	:	US
Telephone Number	:	937-641-5072
Fax Number	:	937-641-6129

Provider Business Practice Location Address
First Line	:	1816 HARVARD BLVD
Second Line	:	STE. 202
City	:	DAYTON
State	:	OH
Zip	:	45404
Country	:	US
Telephone Number	:	937-641-3401
Fax Number	:	937-641-3046

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

Provider Enumeration Date	:	12/06/2016
Last Update Date	:	04/02/2026

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