Healthcare Provider Details

I. General information

NPI: 1619518255
Provider Name (Legal Business Name): TRUE DIRECTION COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26442 KIME HOLDERMAN RD
CIRCLEVILLE OH
43113-8983
US

IV. Provider business mailing address

PO BOX 604
CIRCLEVILLE OH
43113-0604
US

V. Phone/Fax

Practice location:
  • Phone: 740-412-4524
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DENISE VAN GUNDY
Title or Position: OWNER
Credential: LISW-S
Phone: 740-412-4524