MEDICARE: DIVINE COMFORT AND COUNSELING 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
1	251S00000X	Community/Behavioral Health Agency	S.1201403	OH
2	251S00000X	Community/Behavioral Health Agency	ICDC.141066	OH

General Provider Information

NPI Number	:	1215394853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE COMFORT AND COUNSELING LLC

Provider Business Mailing Address
First Line	:	5818 WILMINGTON PIKE
Second Line	:	PMB 207
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-7004
Country	:	US
Telephone Number	:	937-301-5549
Fax Number	:

Provider Business Practice Location Address
First Line	:	7133 OLD TROY PIKE
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-2658
Country	:	US
Telephone Number	:	937-301-5549
Fax Number	:

Authorized Official
Title or Position	:	OWNER/LICDC, LSW
Name	:	BRIDGETTE D HERREN
Credential	:
Telephone Number	:	937-301-5549

Provider Enumeration Date	:	01/27/2016
Last Update Date	:	03/10/2025

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