Provider Demographics
NPI:1043646755
Name:GEORGILIS, ABIGAILE L (MA, LPCC-S)
Entity Type:Individual
Prefix:
First Name:ABIGAILE
Middle Name:L
Last Name:GEORGILIS
Suffix:
Gender:F
Credentials:MA, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7864 CAMARGO RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-2652
Mailing Address - Country:US
Mailing Address - Phone:859-468-3212
Mailing Address - Fax:
Practice Address - Street 1:7864 CAMARGO RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243-2652
Practice Address - Country:US
Practice Address - Phone:859-468-3212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1200550-SUPV101YM0800X
OHLICDC.141204101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)