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NPI Code Detail

MEDICARE: ABBEY CARTER LOGAN LPCC-S

MEDICARE: ABBEY CARTER LOGAN LPCC-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE.0800149-SUPVOH

General Provider Information

NPI Number : 1255879557
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBEY CARTER LOGAN LPCC-S
Provider Business Mailing Address
First Line : 188 ALDRICH RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43214-2554
Country : US
Telephone Number : 614-893-1205
Fax Number :
Provider Business Practice Location Address
First Line : 5354 N HIGH ST STE 206
Second Line : CLINTONVILLE COUNSELING AND WELLNESS
City : COLUMBUS
State : OH
Zip : 43214-1274
Country : US
Telephone Number : 614-948-7300
Fax Number : 614-948-7300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2017
Last Update Date : 02/07/2017

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Directions to “ ABBEY CARTER LOGAN LPCC-S” Practice Location

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