Individual
JERALYN RENEE THARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-S LICDC
Contact information
Practice address
8139 OLD TROY PIKE # 1031, HUBER HEIGHTS, OH 45424-1067
(937) 712-5893
(937) 962-6210
Mailing address
8139 OLD TROY PIKE # 1031, HUBER HEIGHTS, OH 45424-1067
(937) 712-5893
(937) 962-6210
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
E.1800797
OH
101YP2500X
Professional Counselor
Primary
E.1800797
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0310025
MEDICAID
OH
01
—
G0332295
MEDICAID
OH
05
—
G0332295
—
OH
Enumeration date
10/13/2009
Last updated
12/10/2025
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