Provider Demographics
NPI:1568625911
Name:POINDEXTER, MICHAEL (LPCC, LICDC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:POINDEXTER
Suffix:
Gender:M
Credentials:LPCC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9641 WATERFORD PL APT 205
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6233
Mailing Address - Country:US
Mailing Address - Phone:513-239-3950
Mailing Address - Fax:
Practice Address - Street 1:9641 WATERFORD PL APT 205
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-6233
Practice Address - Country:US
Practice Address - Phone:513-239-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0004120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health