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General NPI Number Information
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NPI Number | 1972992576
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Entity Type | Organization
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Legal Business Name | W. JOSEPH HAMBOR LISW-S
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Dates
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Enumeration Date | 01/20/2015
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Last Update Date | 01/20/2015
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Provider Practice Location Address
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Address Line | 5 W CHURCH ST
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City | PICKERINGTON
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State | OH
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Zip | 43147-1210
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Country | US
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Telephone | 614-787-3843
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Fax | 614-321-6253
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Provider Business Mailing Address
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Address Line | 5 W CHURCH ST
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City | PICKERINGTON
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State | OH
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Zip | 43147-1210
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Country | US
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Telephone | 614-787-3843
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Fax | 614-321-6253
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. WILLIAM JOSEPH HAMBOR
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Credential | LISW-S
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Telephone | 614-787-3843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | I0003808
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | I0003808
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License Number State | OH
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