Healthcare Provider Details

I. General information

NPI: 1518359819
Provider Name (Legal Business Name): OUTREACH AND CRISIS COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2015
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1547 W BROAD ST
COLUMBUS OH
43222-1043
US

IV. Provider business mailing address

1547 W BROAD ST
COLUMBUS OH
43222-1043
US

V. Phone/Fax

Practice location:
  • Phone: 614-352-2620
  • Fax: 614-675-2577
Mailing address:
  • Phone: 614-352-2620
  • Fax: 614-675-2577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number121039
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. MICHELLE ANNETTE BAYS
Title or Position: OWNER/OPERATOR
Credential: LICDC
Phone: 614-352-2620