=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811635592
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANIMAL COMPANION COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2022
-----------------------------------------------------
Last Update Date | 06/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 516 LINN ST STE 502
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45203-1743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-014-5145
-----------------------------------------------------
Fax | 513-837-9945
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 505 STANLEY AVE
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45226-1720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-702-0016
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-FOUNDER
-----------------------------------------------------
Name | JESSICA HAGEN
-----------------------------------------------------
Credential | LPCC-S
-----------------------------------------------------
Telephone | 513-702-0016
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------