Basic Information
| Provider Information | |||||||||
| NPI: | 1760792014 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NORTHCOMMUNITYCOUNSELING CENTERS,INC. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 4897 KARL RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432295147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148462588 | ||||||||
| FaxNumber: | 6148469759 | ||||||||
| Practice Location | |||||||||
| Address1: | 4897 KARL RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432295147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148462588 | ||||||||
| FaxNumber: | 6148469759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2010 | ||||||||
| LastUpdateDate: | 10/20/2010 | ||||||||
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| AuthorizedOfficialLastName: | KITTREDGE | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6148462588 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | S0005309 | OH | Y | Agencies | Case Management |
No ID Information.