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Individual

MR. JIM OLDERHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPCC, CDCA

Contact information

Practice address
325 S ELM ST, HILLSBORO, OH 45133-1305
(937) 661-1682
Mailing address
325 S ELM ST, HILLSBORO, OH 45133-1305
(937) 661-1682

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C1500082
OH
101YM0800X
Mental Health Counselor
Primary
E1901459
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
292528
OH
Enumeration date
03/14/2016
Last updated
03/09/2020
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