Healthcare Provider Details

I. General information

NPI: 1245838630
Provider Name (Legal Business Name): MIDWEST COUNSELING CENTERS OF OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 KINGSRIDGE DR STE 106
DAYTON OH
45458-1632
US

IV. Provider business mailing address

8940 KINGSRIDGE DR STE 106
DAYTON OH
45458-1632
US

V. Phone/Fax

Practice location:
  • Phone: 937-813-4485
  • Fax: 937-813-4576
Mailing address:
  • Phone: 937-813-4485
  • Fax: 937-813-4576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARK K FLORO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 937-813-4485