Provider Demographics
NPI:1801185723
Name:DOBSON, CRAIG NICHOLAS (LPCC-S)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:NICHOLAS
Last Name:DOBSON
Suffix:
Gender:M
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 COVEDALE LN
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-2615
Mailing Address - Country:US
Mailing Address - Phone:513-400-3836
Mailing Address - Fax:
Practice Address - Street 1:1334 COVEDALE LN
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:OH
Practice Address - Zip Code:45102-2615
Practice Address - Country:US
Practice Address - Phone:513-400-3836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLE-00039234101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLE-00039234OtherLICENSED PROFESSIONAL CLINICAL COUNSELOR - TRAINING SUPERVISION DESIGNATION