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General NPI Number Information
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NPI Number | 1346615010
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Entity Type | Organization
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Legal Business Name | THREE C COUNSELING, INC
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 28 PARK AVE W 300
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City | MANSFIELD
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State | OH
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Zip | 44902-1648
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Country | US
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Telephone | 419-522-5015
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Fax | 419-522-5017
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Provider Business Mailing Address
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Address Line | 28 PARK AVE W 300
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City | MANSFIELD
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State | OH
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Zip | 44902-1648
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Country | US
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Telephone | 419-522-5015
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Fax | 419-522-5017
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Authorized Official
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Title or Position | CEO
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Name | TIMOTHY BATDORF
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Credential | LICDC, SAP
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Telephone | 419-522-5015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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