Provider Demographics
NPI:1912108747
Name:MATTHEWS, VICKI KLUENER (LPCC)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:KLUENER
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5403 BLUEPINE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7412
Mailing Address - Country:US
Mailing Address - Phone:512-574-5167
Mailing Address - Fax:513-619-9827
Practice Address - Street 1:8354 PRINCETON GLENDALE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5879
Practice Address - Country:US
Practice Address - Phone:513-574-5167
Practice Address - Fax:513-619-9827
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional