Individual
MARISA M BADGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPCC-S , LICDC
Contact information
Practice address
5335 FAR HILLS AVE STE 211, DAYTON, OH 45429-2317
(937) 221-8434
Mailing address
5335 FAR HILLS AVE STE 211, DAYTON, OH 45429-2317
(937) 221-8434
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
151092
OH
101YP2500X
Professional Counselor
Primary
E.1200246
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0226088
—
OH
Enumeration date
09/26/2013
Last updated
05/29/2019
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