Provider Demographics
NPI:1083329528
Name:WEBER, COLLEEN MARIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MARIE
Last Name:WEBER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:MARIE
Other - Last Name:DUEBBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CT
Mailing Address - Street 1:9200 MONTGOMERY RD
Mailing Address - Street 2:BUILDING D, SUITE 15B
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7730
Mailing Address - Country:US
Mailing Address - Phone:513-600-2554
Mailing Address - Fax:
Practice Address - Street 1:9200 MONTGOMERY RD
Practice Address - Street 2:BUILDING D, SUITE 15B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7730
Practice Address - Country:US
Practice Address - Phone:513-600-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2304834101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional