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General NPI Number Information
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NPI Number | 1760741110
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Entity Type | Organization
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Legal Business Name | DELAWARE COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 09/16/2015
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Provider Practice Location Address
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Address Line | 21 W CENTRAL AVE
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City | DELAWARE
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State | OH
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Zip | 43015-1911
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Country | US
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Telephone | 614-946-7571
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Fax | 740-879-2826
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Provider Business Mailing Address
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Address Line | 21 W CENTRAL AVE
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City | DELAWARE
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State | OH
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Zip | 43015-1911
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Country | US
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Telephone | 614-946-7571
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Fax | 740-879-2826
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Authorized Official
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Title or Position | OWNER
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Name | KELLIE J DAWSON
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Credential | LISW-S
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Telephone | 614-946-7571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | I. 0009062 SUPV
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License Number State | OH
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