Healthcare Provider Details

I. General information

NPI: 1760792014
Provider Name (Legal Business Name): NORTHCOMMUNITYCOUNSELING CENTERS,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4897 KARL RD
COLUMBUS OH
43229-5147
US

IV. Provider business mailing address

4897 KARL RD
COLUMBUS OH
43229-5147
US

V. Phone/Fax

Practice location:
  • Phone: 614-846-2588
  • Fax: 614-846-9759
Mailing address:
  • Phone: 614-846-2588
  • Fax: 614-846-9759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberS0005309
License Number StateOH

VIII. Authorized Official

Name: MR. DAVID KITTREDGE
Title or Position: PRESIDENT
Credential:
Phone: 614-846-2588