Healthcare Provider Details

I. General information

NPI: 1326773490
Provider Name (Legal Business Name): NEW SEASON CLINICAL COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 HENDERSON RD
COLUMBUS OH
43220-4388
US

IV. Provider business mailing address

3260 HENDERSON RD
COLUMBUS OH
43220-4388
US

V. Phone/Fax

Practice location:
  • Phone: 614-642-2600
  • Fax:
Mailing address:
  • Phone: 614-642-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SEASON DAWN SHIPE
Title or Position: DIRECTOR
Credential: LISW
Phone: 614-642-2600