Healthcare Provider Details
I. General information
NPI: 1821769324
Provider Name (Legal Business Name): OHIO FAMILY COUNSELING AND CONSULTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2021
Last Update Date: 09/23/2021
Certification Date: 09/08/2021
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
- Phone: 740-291-3737
- Fax: 833-805-3653
- Phone: 740-291-3737
- Fax: 833-805-3653
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LESLIE
FEHRMAN RIDENBAUGH
Title or Position: CEO
Credential: LISW-S, LICDC-CS
Phone: 740-291-3737