Provider Demographics
NPI:1598947954
Name:NIEHAUS, PEG HENNESSEY (PC)
Entity Type:Individual
Prefix:MRS
First Name:PEG
Middle Name:HENNESSEY
Last Name:NIEHAUS
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8035 HOSBROOK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2951
Mailing Address - Country:US
Mailing Address - Phone:513-791-5990
Mailing Address - Fax:513-792-3308
Practice Address - Street 1:8035 HOSBROOK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2951
Practice Address - Country:US
Practice Address - Phone:513-791-5990
Practice Address - Fax:513-792-3308
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0500468101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional