Provider Demographics
NPI:1679944714
Name:ROHAN, BRIAN K (LPC, LICDC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:K
Last Name:ROHAN
Suffix:
Gender:M
Credentials:LPC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9512 SHORT LINE CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-3962
Mailing Address - Country:US
Mailing Address - Phone:513-403-9368
Mailing Address - Fax:
Practice Address - Street 1:6058 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-1612
Practice Address - Country:US
Practice Address - Phone:513-403-9368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHICDC.151013101YA0400X
OHC.1300715101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health