=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861531352
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHIRLEY K VERHEY LPCC-S
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2007
-----------------------------------------------------
Last Update Date | 03/17/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 647 HILL RD N STE. B
-----------------------------------------------------
City | PICKERINGTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43147-9168
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-833-6900
-----------------------------------------------------
Fax | 614-833-6903
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 711 N COLUMBUS ST STE 100
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43130-2538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-653-6500
-----------------------------------------------------
Fax | 740-653-6501
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | E0002109SUPV
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------