Healthcare Provider Details

I. General information

NPI: 1447871694
Provider Name (Legal Business Name): VIOLETA COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 04/29/2020
Certification Date: 04/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 E MAIN ST STE 106
BEXLEY OH
43209-2536
US

IV. Provider business mailing address

2700 E MAIN ST STE 106
BEXLEY OH
43209-2536
US

V. Phone/Fax

Practice location:
  • Phone: 614-330-0732
  • Fax:
Mailing address:
  • Phone: 614-330-0732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: VIOLETA G. FOWLER
Title or Position: COUNSELOR
Credential: LMHC, LPCC-S
Phone: 614-330-0732