Provider Demographics
NPI:1851833115
Name:EDELMANN, JANE GENTILE (MA, LPCC, CSAT)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:GENTILE
Last Name:EDELMANN
Suffix:
Gender:F
Credentials:MA, LPCC, CSAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-2541
Mailing Address - Country:US
Mailing Address - Phone:513-602-2740
Mailing Address - Fax:
Practice Address - Street 1:8044 MONTGOMERY RD
Practice Address - Street 2:SUITE 700
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2919
Practice Address - Country:US
Practice Address - Phone:513-602-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1100187101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1174944615OtherCOUNSELING ALLIANCE PLLC