Healthcare Provider Details

I. General information

NPI: 1942164223
Provider Name (Legal Business Name): VAN WERT COUNSELING OFFICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1054 S WASHINGTON ST STE B
VAN WERT OH
45891-1476
US

IV. Provider business mailing address

1054 S WASHINGTON ST STE B
VAN WERT OH
45891-1476
US

V. Phone/Fax

Practice location:
  • Phone: 419-238-1000
  • Fax:
Mailing address:
  • Phone: 419-238-1000
  • Fax: 419-238-1071

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 State

VIII. Authorized Official

Name: KATLYN SHORT
Title or Position: OWNER
Credential: MSW, LISW-S
Phone: 419-238-1000