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General NPI Number Information
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NPI Number | 1578375937
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Entity Type | Organization
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Legal Business Name | SKYWAY COUNSELING LLC
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 4847 EASTERN AVE
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City | CINCINNATI
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State | OH
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Zip | 45208-4450
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Country | US
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Telephone | 513-399-6843
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Fax |
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Provider Business Mailing Address
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Address Line | 3618 DAVENANT AVE
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City | CINCINNATI
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State | OH
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Zip | 45213-2108
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Country | US
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Telephone | 513-518-2102
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MADELYNNE CAMPBELL
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Credential | LPC
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Telephone | 513-399-6843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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