Provider Demographics
NPI:1083125371
Name:KHAN, MICHELLE (LPCC-S)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11804 CONREY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-1072
Mailing Address - Country:US
Mailing Address - Phone:513-984-1000
Mailing Address - Fax:
Practice Address - Street 1:11804 CONREY RD STE 100
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-1076
Practice Address - Country:US
Practice Address - Phone:513-984-1000
Practice Address - Fax:513-985-2182
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1800826101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health