Provider Demographics
NPI:1154554905
Name:PRICE, STEPHEN WARREN (LICDC)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:WARREN
Last Name:PRICE
Suffix:
Gender:M
Credentials:LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 WILLIAMSBURG LN
Mailing Address - Street 2:
Mailing Address - City:SHARONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45241-1455
Mailing Address - Country:US
Mailing Address - Phone:513-858-2000
Mailing Address - Fax:513-858-2888
Practice Address - Street 1:1130 CONGRESS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4484
Practice Address - Country:US
Practice Address - Phone:513-858-2000
Practice Address - Fax:513-858-2888
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH943972101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)