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General NPI Number Information
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NPI Number | 1457754384
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Entity Type | Organization
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Legal Business Name | PRIME BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 647 HILL RD N STE B
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City | PICKERINGTON
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State | OH
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Zip | 43147-9168
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Country | US
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Telephone | 614-833-6900
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Fax | 614-833-6903
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Provider Business Mailing Address
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Address Line | 711 N COLUMBUS ST STE. 100
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City | LANCASTER
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State | OH
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Zip | 43130-2538
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Country | US
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Telephone | 740-653-6500
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Fax | 740-653-6501
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | WILLIAM R HARGETT
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Credential | MA, LPCC-S
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Telephone | 614-833-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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