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General NPI Number Information
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NPI Number | 1013183128
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Entity Type | Organization
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Legal Business Name | SUSANNAH L. ABRAHAM, LLC
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 6797 N HIGH ST SUITE 155
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City | WORTHINGTON
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State | OH
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Zip | 43085-2533
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Country | US
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Telephone | 614-634-6624
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Fax |
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Provider Business Mailing Address
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Address Line | 6797 N HIGH ST SUITE 155
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City | WORTHINGTON
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State | OH
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Zip | 43085-2533
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Country | US
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Telephone | 614-634-6624
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Fax |
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Authorized Official
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Title or Position | OWNER/PROFESSIONAL COUNSELOR
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Name | SUSANNAH L ABRAHAM
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Credential | MED, LPC
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Telephone | 614-634-6624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C 0500891
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License Number State | OH
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