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General NPI Number Information
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NPI Number | 1215394853
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Entity Type | Organization
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Legal Business Name | DIVINE COMFORT AND COUNSELING LLC
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 7133 OLD TROY PIKE
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-2658
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Country | US
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Telephone | 937-301-5549
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Fax |
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Provider Business Mailing Address
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Address Line | 5818 WILMINGTON PIKE PMB 207
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City | CENTERVILLE
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State | OH
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Zip | 45459-7004
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Country | US
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Telephone | 937-301-5549
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Fax |
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Authorized Official
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Title or Position | OWNER/LICDC, LSW
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Name | BRIDGETTE D HERREN
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Credential |
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Telephone | 937-301-5549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | S.1201403
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | ICDC.141066
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License Number State | OH
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