Provider Demographics
NPI:1295243400
Name:VIKEN, MYCAH JEAN (MA, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:MYCAH
Middle Name:JEAN
Last Name:VIKEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1879 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9946
Mailing Address - Country:US
Mailing Address - Phone:513-695-2900
Mailing Address - Fax:513-695-2961
Practice Address - Street 1:1879 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-9946
Practice Address - Country:US
Practice Address - Phone:513-695-2900
Practice Address - Fax:513-695-2961
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP16001235Z00000X
OHCOND.20211758-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty