Healthcare Provider Details

I. General information

NPI: 1487600094
Provider Name (Legal Business Name): BAYSHORE COUNSELING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1634 SYCAMORE LINE
SANDUSKY OH
44870
US

IV. Provider business mailing address

1634 SYCAMORE LINE
SANDUSKY OH
44870
US

V. Phone/Fax

Practice location:
  • Phone: 419-626-9156
  • Fax: 419-621-0099
Mailing address:
  • Phone: 419-626-9156
  • Fax: 419-621-0099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0311
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0311
License Number StateOH

VIII. Authorized Official

Name: ANNEMARIE KATZ
Title or Position: SUPPORT SUPERVISOR
Credential:
Phone: 419-626-9156