| Doctor Name: | MR. JIM OLDERHAM |
| NPI Number: | 1013378470 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC, CDCA |
| License Number: | C1500082 |
| Business Practice Address: | 111 W Water St Chillicothe, OH - 456012423 |
| Business Phone Number: | 7408514432 |
| Business Fax Number: | 7407721024 |
| Mailing Address: | 325 S Elm St, HILLSBORO |
| State: | OH |
| Postal Code: | 451331305 |
| Phone Number: | 9376611682 |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2016 |
| NPI Last Update Date: | 03/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | C1500082 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |