Organization
SAM NABIL COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUSSAM FATAHALLA LPC (LICENSED PROFESSIONAL COUNSELOR)
(513) 549-5341
Entity
Organization
Contact information
Practice address
4555 LAKE FOREST DR, BLUE ASH, OH 45242-3785
(513) 549-5341
Mailing address
4555 LAKE FOREST DR, BLUE ASH, OH 45242-3785
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C.1400210
OH
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
C.1400210
OH
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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