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Individual

CHRISTINE MCCOLLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICDC, OCPSII, MACM

Contact information

Practice address
930 TRAILWOOD DR, BOARDMAN, OH 44512-5007
(513) 834-7063
Mailing address
615 ELSINORE PL STE 200, CINCINNATI, OH 45202-1459
(513) 834-7063
(513) 873-1567

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.111100
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC111100
OH
405300000X
Prevention Professional
OCPC1061
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0199144
OH
Enumeration date
04/07/2014
Last updated
11/30/2020
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