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NPI Code Detail

MEDICARE: SOUTHEAST COMMUNITY MENTAL HEALTH CENTER

MEDICARE: SOUTHEAST COMMUNITY MENTAL HEALTH CENTER
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
1251S00000XCommunity/Behavioral Health AgencyS.1440478OH

General Provider Information

NPI Number : 1073044004
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHEAST COMMUNITY MENTAL HEALTH CENTER
Provider Business Mailing Address
First Line : 1455 S 4TH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-1011
Country : US
Telephone Number : 614-327-9008
Fax Number :
Provider Business Practice Location Address
First Line : 1455 S 4TH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-1011
Country : US
Telephone Number : 614-327-9008
Fax Number :
Authorized Official
Title or Position : SOCIAL WORKER
Name : BRITTNEY DANGLER
Credential : LISW
Telephone Number : 614-444-0800
Provider Enumeration Date : 03/22/2017
Last Update Date : 08/09/2018

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Directions to “SOUTHEAST COMMUNITY MENTAL HEALTH CENTER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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