Healthcare Provider Details

I. General information

NPI: 1699681387
Provider Name (Legal Business Name): SOUTH CENTRAL OHIO ESC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4057 GALLIA PIKE
FRANKLIN FURNACE OH
45629-8811
US

IV. Provider business mailing address

460 GLEIM RD
WHEELERSBURG OH
45694-8377
US

V. Phone/Fax

Practice location:
  • Phone: 740-354-9221
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIC REZA MOHEBBIAN
Title or Position: SCHOOL PSYCHOLOGIST
Credential: BA, MA, ED.S
Phone: 740-352-8195