Provider Demographics
NPI:1023142833
Name:NORDLOH, MARY C (LPCC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:C
Last Name:NORDLOH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 VERA CRUZ DR
Mailing Address - Street 2:
Mailing Address - City:VILLA HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1035
Mailing Address - Country:US
Mailing Address - Phone:859-331-5358
Mailing Address - Fax:
Practice Address - Street 1:7000 HOUSTON RD
Practice Address - Street 2:SUITE 29 AND 30
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4873
Practice Address - Country:US
Practice Address - Phone:859-746-9272
Practice Address - Fax:859-746-9322
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0003681101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional