=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164385993
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COLUMBUS GROVE COUNSELING SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2025
-----------------------------------------------------
Last Update Date | 12/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 204 N HIGH ST
-----------------------------------------------------
City | COLUMBUS GROVE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45830-1205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-659-5998
-----------------------------------------------------
Fax | 419-659-3083
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 307 S JOHNSON ST
-----------------------------------------------------
City | ADA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45810-1425
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 567-305-6380
-----------------------------------------------------
Fax | 419-634-1670
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. RICK J D'ARCA
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 419-303-1992
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------