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General NPI Number Information
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NPI Number | 1699491779
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Entity Type | Organization
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Legal Business Name | ONE RECOVERY COMPANY LLC
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 15 BISHOP DR
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City | WESTERVILLE
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State | OH
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Zip | 43081-2275
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Country | US
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Telephone | 614-506-5789
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 88
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City | BLACKLICK
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State | OH
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Zip | 43004-0088
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Country | US
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Telephone | 614-506-5789
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEVIN TREVATHAN
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Credential | LPC
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Telephone | 614-506-5789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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