Healthcare Provider Details

I. General information

NPI: 1679323547
Provider Name (Legal Business Name): FORT MEIGS WELLNESS & BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 COMMERCE DR
PERRYSBURG OH
43551-5228
US

IV. Provider business mailing address

975 COMMERCE DR
PERRYSBURG OH
43551-5228
US

V. Phone/Fax

Practice location:
  • Phone: 419-874-8257
  • Fax: 419-873-7584
Mailing address:
  • Phone: 419-874-8257
  • Fax: 419-873-7584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JANET CAUGHHORN
Title or Position: OFFICE MANAGER
Credential:
Phone: 419-874-8257