Healthcare Provider Details

I. General information

NPI: 1720044506
Provider Name (Legal Business Name): MARION AREA COUNSELING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 EXECUTIVE DR
MARION OH
43302-6310
US

IV. Provider business mailing address

320 EXECUTIVE DR
MARION OH
43302-6310
US

V. Phone/Fax

Practice location:
  • Phone: 740-387-5210
  • Fax: 740-382-3713
Mailing address:
  • Phone: 740-387-5210
  • Fax: 740-382-3713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateOH

VIII. Authorized Official

Name: MS. BEVERLY YOUNG
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 740-387-5210