Healthcare Provider Details

I. General information

NPI: 1518796267
Provider Name (Legal Business Name): TABATHA L WOOD FEUCHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 OAK MEADOW DR STE 15
PATASKALA OH
43062-9812
US

IV. Provider business mailing address

132 E MAIN ST
LANCASTER OH
43130-3712
US

V. Phone/Fax

Practice location:
  • Phone: 614-863-6068
  • Fax:
Mailing address:
  • Phone: 614-404-5923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2614349
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.196378
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: