Basic Information
| Provider Information | |||||||||
| NPI: | 1518359819 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OUTREACH AND CRISIS COUNSELING SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1547 W BROAD ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432221043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143522620 | ||||||||
| FaxNumber: | 6146752577 | ||||||||
| Practice Location | |||||||||
| Address1: | 1547 W BROAD ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432221043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143522620 | ||||||||
| FaxNumber: | 6146752577 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2015 | ||||||||
| LastUpdateDate: | 09/15/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BAYS | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
| AuthorizedOfficialMiddleName: | ANNETTE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/OPERATOR | ||||||||
| AuthorizedOfficialTelephone: | 6143522620 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LICDC | ||||||||
| NPICertificationDate: | 09/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | N | Agencies | Community/Behavioral Health | 261QR0405X | 121039 | OH | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.