Healthcare Provider Details

I. General information

NPI: 1073981353
Provider Name (Legal Business Name): FOCUS COUNSELING CLINIC, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 09/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

781 NORTHWEST BLVD STE 206
GRANDVIEW HEIGHTS OH
43212-3878
US

IV. Provider business mailing address

3417 COURTLAND DR
LEWIS CENTER OH
43035-9185
US

V. Phone/Fax

Practice location:
  • Phone: 614-312-7917
  • Fax:
Mailing address:
  • Phone: 614-312-7917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberICDC.121130
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE.1100299
License Number StateOH

VIII. Authorized Official

Name: OLAJUMOKE Y OLAWALE
Title or Position: CEO/OWNER
Credential: MA, LPCC, LICDC.
Phone: 614-312-7917