Healthcare Provider Details

I. General information

NPI: 1053941237
Provider Name (Legal Business Name): OHIO FAMILY COUNSELING AND CONSULTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 MAIN ST
COSHOCTON OH
43812-1612
US

IV. Provider business mailing address

PO BOX 1311
COSHOCTON OH
43812-6311
US

V. Phone/Fax

Practice location:
  • Phone: 740-291-3737
  • Fax: 833-805-3653
Mailing address:
  • Phone: 740-291-3737
  • Fax: 833-805-3653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LESLIE FEHRMAN RIDENBAUGH
Title or Position: CEO
Credential: LISW-S
Phone: 740-291-3737