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General NPI Number Information
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NPI Number | 1568361970
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Entity Type | Organization
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Legal Business Name | SURVIVE TO THRIVE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 4770 INDIANOLA AVE STE LL-13
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City | COLUMBUS
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State | OH
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Zip | 43214-1862
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Country | US
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Telephone | 614-680-3828
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Fax |
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Provider Business Mailing Address
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Address Line | 4770 INDIANOLA AVE
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City | COLUMBUS
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State | OH
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Zip | 43214-1862
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/ FOUNDER
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Name | ANGELETTA L FAIR
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Credential | FAIR
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Telephone | 614-680-3838
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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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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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