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General NPI Number Information
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NPI Number | 1356327308
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY & ADDICTION SRVCS., INC.
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7086 CORPORATE WAY
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City | CENTERVILLE
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State | OH
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Zip | 45459-4224
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Country | US
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Telephone | 937-435-5200
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Fax | 937-435-5200
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Provider Business Mailing Address
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Address Line | 7086 CORPORATE WAY
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City | CENTERVILLE
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State | OH
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Zip | 45459-4224
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Country | US
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Telephone | 937-435-5200
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Fax | 937-435-5200
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Authorized Official
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Title or Position | OWNER
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Name | MS. KATHY SOWDER
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Credential | LPCC, CCDC, III E
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Telephone | 937-435-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E0000363
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License Number State | OH
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