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NPI Code Detail

MEDICARE: SHAWNEE COUNSELING CENTER LLC

MEDICARE: SHAWNEE COUNSELING CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1033695051
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHAWNEE COUNSELING CENTER LLC
Provider Business Mailing Address
First Line : 741 2ND ST
Second Line :
City : PORTSMOUTH
State : OH
Zip : 45662-4001
Country : US
Telephone Number : 740-354-5562
Fax Number : 740-353-1275
Provider Business Practice Location Address
First Line : 519 COURT ST
Second Line :
City : PORTSMOUTH
State : OH
Zip : 45662-3933
Country : US
Telephone Number : 740-876-4370
Fax Number :
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : MICHAEL SEAN STURGILL
Credential : RPH
Telephone Number : 740-821-5084
Provider Enumeration Date : 07/12/2018
Last Update Date : 07/31/2024

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Directions to “SHAWNEE COUNSELING CENTER LLC ” Practice Location

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