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General NPI Number Information
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NPI Number | 1780493254
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Entity Type | Organization
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Legal Business Name | CRISSY BONTRAGER, LLC
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 5990 WILCOX PL STE F
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City | DUBLIN
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State | OH
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Zip | 43016-9266
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Country | US
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Telephone | 614-662-4965
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Fax | 614-505-2027
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Provider Business Mailing Address
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Address Line | 7895 SARAHURST DR
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City | DUBLIN
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State | OH
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Zip | 43016-9071
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Country | US
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Telephone | 614-662-4965
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Fax | 614-505-2720
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Authorized Official
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Title or Position | OWNER
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Name | CRISSY BONTRAGER
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Credential | LPCC-S
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Telephone | 614-662-4965
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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