Provider Demographics
NPI:1518657337
Name:MCILWAIN, CHRISTIN MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:MICHELLE
Last Name:MCILWAIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10945 REED HARTMAN HWY STE 207
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2853
Mailing Address - Country:US
Mailing Address - Phone:513-223-3557
Mailing Address - Fax:
Practice Address - Street 1:10945 REED HARTMAN HWY STE 207
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2853
Practice Address - Country:US
Practice Address - Phone:513-223-3557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2305068101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional