Provider Demographics
NPI:1679934095
Name:PREMIER COUNSELING AND COACHING SERVICES, LLC
Entity type:Organization
Organization Name:PREMIER COUNSELING AND COACHING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ELLIS
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:513-240-8558
Mailing Address - Street 1:8595 BEECHMONT AVE
Mailing Address - Street 2:303
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-4783
Mailing Address - Country:US
Mailing Address - Phone:513-240-8558
Mailing Address - Fax:
Practice Address - Street 1:8595 BEECHMONT AVE
Practice Address - Street 2:303
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4783
Practice Address - Country:US
Practice Address - Phone:513-240-8558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-12
Last Update Date:2016-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHICDC 882422-CS101YA0400X
OHE0016706101YM0800X
OHS.0016706104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty