Individual
AMY HAAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC-SUPV
Contact information
Practice address
9378 S MASON MONTGOMERY RD # 450, MASON, OH 45040-8827
(513) 849-8162
Mailing address
9378 S MASON MONTGOMERY RD # 450, MASON, OH 45040-8827
(513) 849-8162
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E.1901528-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074861
ODADAS
OH
01
—
0074946
ODMH
OH
01
—
01-0963
CARF
OH
01
—
H130910
PTAN GROUP
OH
Enumeration date
11/07/2017
Last updated
05/12/2025
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