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Provider Information for 1427608207


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Mr. PATRICK HENRY MA, MA, LPC, LPCC


Sex: Male

NPI: 1427608207
Last Updated: 2024-08-07
Certification Date: 2024-08-07

Details

NameValue
NPI1427608207
Enumeration Date2019-09-13
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address PO BOX 396
SPRINGBORO, OH 45066-0396
United States

Phone: 720-270-7890 | Fax:
 
Primary Practice Address 3012 GLENMORE AVE
CINCINNATI, OH 45238-2269
United States

Phone: 720-270-7890 | Fax:
 
Secondary Practice Address(es)

1445 W MAIN ST
NEWARK, OH 43055-1824
United States

Phone: 833-510-4357 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDOH0410908
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YP2500X - Counselor - ProfessionalOHE.2303839
Yes 101YP2500X - Counselor - ProfessionalOHC.1902256