Healthcare Provider Details

I. General information

NPI: 1083999833
Provider Name (Legal Business Name): POSITIVE PATH COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2011
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6055 TAIN DR STE 104
DUBLIN OH
43017-8449
US

IV. Provider business mailing address

9022 MOORS PL N
DUBLIN OH
43017-9048
US

V. Phone/Fax

Practice location:
  • Phone: 614-588-0303
  • Fax: 614-588-0303
Mailing address:
  • Phone: 614-339-0424
  • Fax: 614-339-0425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberI00008428
License Number StateOH

VIII. Authorized Official

Name: CHRISTOPHER P FRASER
Title or Position: OWNER
Credential: LISW
Phone: 614-588-0303