Healthcare Provider Details

I. General information

NPI: 1992785174
Provider Name (Legal Business Name): MUSKINGUM COUNTY DRUG, ALCOHOL AND SUBSTANCE ABUSE COUNCIL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 W MAIN ST
ZANESVILLE OH
43701-3147
US

IV. Provider business mailing address

1127 W MAIN ST
ZANESVILLE OH
43701-3147
US

V. Phone/Fax

Practice location:
  • Phone: 740-454-1266
  • Fax: 740-454-7650
Mailing address:
  • Phone: 740-454-1266
  • Fax: 740-454-7650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number01422
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number01422
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number01422
License Number StateOH

VIII. Authorized Official

Name: GAYLE STEIL
Title or Position: CFO
Credential:
Phone: 740-454-1266