Healthcare Provider Details

I. General information

NPI: 1790296499
Provider Name (Legal Business Name): DAVID HUTCHINSON LICDC, LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2017
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E COLUMBUS AVE STE 1
BELLEFONTAINE OH
43311-2033
US

IV. Provider business mailing address

212 E COLUMBUS AVE STE 1
BELLEFONTAINE OH
43311-2033
US

V. Phone/Fax

Practice location:
  • Phone: 937-599-1411
  • Fax: 937-599-4128
Mailing address:
  • Phone: 937-599-1411
  • Fax: 937-599-4128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.162744
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2005163
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: