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General NPI Number Information
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NPI Number | 1902773039
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Entity Type | Organization
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Legal Business Name | SOUTHERN OHIO BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 602 CHILLICOTHE ST STE M104
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4039
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Country | US
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Telephone | 740-935-1076
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Fax |
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Provider Business Mailing Address
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Address Line | 602 CHILLICOTHE ST STE M104
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4039
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Country | US
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Telephone | 740-935-1076
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | ANGELA DYKE
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Credential | MSW,LISW-S
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Telephone | 740-935-1076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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