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General NPI Number Information
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NPI Number | 1760735229
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Entity Type | Organization
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Legal Business Name | URGENT CARE COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 2525 W BANCROFT ST
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City | TOLEDO
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State | OH
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Zip | 43607-1311
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Country | US
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Telephone | 419-578-2525
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Fax | 419-536-9220
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Provider Business Mailing Address
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Address Line | 2525 W BANCROFT ST
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City | TOLEDO
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State | OH
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Zip | 43607-1311
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Country | US
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Telephone | 419-578-2525
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Fax | 419-536-9220
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Authorized Official
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Title or Position | PRESIDENT
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Name | LINDA WHITTINGTON-CLARK
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Credential | PHD
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Telephone | 419-578-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | E225-S
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License Number State | OH
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