Basic Information
Provider Information
NPI: 1235699224
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUHL
FirstName: JOSH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCDC2
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1791 ALUM CREEK DR
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432071757
CountryCode: US
TelephoneNumber: 6144458131
FaxNumber:  
Practice Location
Address1: 1430 S HIGH ST
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432071045
CountryCode: US
TelephoneNumber: 6144458131
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2019
LastUpdateDate: 04/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X161706OHY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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