Provider Demographics
NPI:1013245380
Name:DENNIS, CELESTE V (LPCC)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:V
Last Name:DENNIS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:V
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:9754 KENWOOD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6159
Mailing Address - Country:US
Mailing Address - Phone:513-445-8445
Mailing Address - Fax:513-759-7013
Practice Address - Street 1:9754 KENWOOD RD
Practice Address - Street 2:SUITE B
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-6159
Practice Address - Country:US
Practice Address - Phone:513-445-8445
Practice Address - Fax:513-759-7013
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2016-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH001428101YA0400X
OHE0003486101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH451928736OtherTAX IDENTIFICATION NUMBER