Provider Demographics
NPI:1487841359
Name:IRELAND, DREW T (LPCC)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:T
Last Name:IRELAND
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5936 GLENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2009
Mailing Address - Country:US
Mailing Address - Phone:513-922-1660
Mailing Address - Fax:513-922-6230
Practice Address - Street 1:5936 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2009
Practice Address - Country:US
Practice Address - Phone:513-922-1660
Practice Address - Fax:513-922-6230
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 0500058101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCI 9282111Medicare PIN