Provider Demographics
NPI:1851644983
Name:SUNIL, KSHEMA (LPCC-S)
Entity Type:Individual
Prefix:MS
First Name:KSHEMA
Middle Name:
Last Name:SUNIL
Suffix:
Gender:F
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 1:401 E. MCMILLAN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206
Mailing Address - Country:US
Mailing Address - Phone:513-221-3350
Mailing Address - Fax:513-475-5673
Practice Address - Street 1:2640 SAINT CHARLES AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-3147
Practice Address - Country:US
Practice Address - Phone:513-505-4943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC11004571041C0700X
OHE.1100457-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical