Provider Demographics
NPI:1336428598
Name:OGLETREE, ERICA D (LPCC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:D
Last Name:OGLETREE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:SANFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PC
Mailing Address - Street 1:11223 CORNELL PARK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-1835
Mailing Address - Country:US
Mailing Address - Phone:513-866-4645
Mailing Address - Fax:513-866-4645
Practice Address - Street 1:11223 CORNELL PARK DR STE 102
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-1835
Practice Address - Country:US
Practice Address - Phone:513-866-4645
Practice Address - Fax:513-866-4600
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1500290-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0213210Medicaid