Provider Demographics
NPI:1922302033
Name:INGRAM, STEVEN A (PCC-S)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:INGRAM
Suffix:
Gender:M
Credentials:PCC-S
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 1:409 E MONUMENT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1260
Practice Address - Country:US
Practice Address - Phone:937-208-6602
Practice Address - Fax:937-208-7088
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0500057101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health