Healthcare Provider Details

I. General information

NPI: 1699749457
Provider Name (Legal Business Name): MID-OHIO PSYCHOLOGICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 STARRET ST STE 100
LANCASTER OH
43130-3993
US

IV. Provider business mailing address

106 STARRET ST STE 100
LANCASTER OH
43130-3993
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-0042
  • Fax: 740-687-6677
Mailing address:
  • Phone: 740-687-0042
  • Fax: 740-687-6677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: AMY R FIGGINS
Title or Position: BILLING MANAGER
Credential:
Phone: 740-687-0042