Healthcare Provider Details

I. General information

NPI: 1255901146
Provider Name (Legal Business Name): DWELLING PLACE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 BEECHER CROSSING NORTH SUITE C
GAHANNA OH
43230-4572
US

IV. Provider business mailing address

1075 BEECHER CROSSING NORTH SUITE C
GAHANNA OH
43230-4572
US

V. Phone/Fax

Practice location:
  • Phone: 614-423-9310
  • Fax: 937-606-3077
Mailing address:
  • Phone: 614-423-9310
  • Fax: 937-606-3077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CANDICE WEST
Title or Position: BILLER/ CREDENTIALLER
Credential:
Phone: 937-360-8434