Provider Demographics
NPI:1508200684
Name:MAYHAUS, CHRISTINA M (LPCC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:MAYHAUS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 WEST ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2523
Mailing Address - Country:US
Mailing Address - Phone:513-317-1767
Mailing Address - Fax:
Practice Address - Street 1:4226 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-3102
Practice Address - Country:US
Practice Address - Phone:513-317-1767
Practice Address - Fax:513-672-2810
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
E.1000224101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0261485Medicaid