Healthcare Provider Details

I. General information

NPI: 1811269707
Provider Name (Legal Business Name): YARA COUNSELING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2012
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 E MAIN ST SUITE B
BEXLEY OH
43209-2579
US

IV. Provider business mailing address

2740 E MAIN ST SUITE B
BEXLEY OH
43209-2579
US

V. Phone/Fax

Practice location:
  • Phone: 614-237-2700
  • Fax:
Mailing address:
  • Phone: 614-237-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0004409-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.0018331
License Number StateOH

VIII. Authorized Official

Name: MRS. ZUBERI YARA
Title or Position: CEO/PCC-S
Credential:
Phone: 614-237-2700