Organization
HYDE PARK VIRTUAL COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEGAN JACK (SOLE PROPRIETOR)
(303) 898-2265
Entity
Organization
Contact information
Practice address
11427 REED HARTMAN HWY # 225, BLUE ASH, OH 45241-2418
(513) 310-8408
Mailing address
11427 REED HARTMAN HWY # 225, BLUE ASH, OH 45241-2418
(513) 310-8408
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0146174
—
OH
Enumeration date
03/07/2024
Last updated
03/31/2026
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