Provider Demographics
NPI:1316148844
Name:GOEBEL, MELISSA J (LPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:J
Last Name:GOEBEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 W KEMPER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-2233
Mailing Address - Country:US
Mailing Address - Phone:513-482-0709
Mailing Address - Fax:
Practice Address - Street 1:10921 REED HARTMAN HWY
Practice Address - Street 2:SUITE 133
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-2830
Practice Address - Country:US
Practice Address - Phone:513-984-9838
Practice Address - Fax:513-984-8075
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-0500133101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor