Provider Demographics
NPI:1750585592
Name:NITSCHKE, ALLISON LEE (LPCC-SUPV)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LEE
Last Name:NITSCHKE
Suffix:
Gender:F
Credentials:LPCC-SUPV
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:LEE
Other - Last Name:NITSCHKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:1430 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-3315
Mailing Address - Country:US
Mailing Address - Phone:513-896-3474
Mailing Address - Fax:
Practice Address - Street 1:1430 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-3315
Practice Address - Country:US
Practice Address - Phone:513-896-3474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC-500301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0213231Medicaid