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General NPI Number Information
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NPI Number | 1073935649
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL COUNSELING SERVICES OF OHIO LLC
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Dates
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Enumeration Date | 01/15/2014
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 300 JAMES BOHANAN DR
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City | VANDALIA
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State | OH
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Zip | 45377-2300
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Country | US
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Telephone | 937-742-7516
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Fax | 937-415-0152
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Provider Business Mailing Address
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Address Line | 300 JAMES BOHANAN DR
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City | VANDALIA
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State | OH
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Zip | 45377-2300
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Country | US
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Telephone | 937-742-7516
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Fax | 937-415-0152
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Authorized Official
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Title or Position | OWNER
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Name | CARLA R URBANAS
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Credential | MS LPCC
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Telephone | 937-742-7516
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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 | E3194
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License Number State | OH
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