MEDICARE: CIRCLEVILLE COMMUNITY 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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1346913779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIRCLEVILLE COMMUNITY COUNSELING, LLC

Provider Business Mailing Address
First Line	:	343 MEADOW LN
Second Line	:
City	:	CIRCLEVILLE
State	:	OH
Zip	:	43113-1436
Country	:	US
Telephone Number	:	740-497-2479
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 N COURT ST
Second Line	:
City	:	CIRCLEVILLE
State	:	OH
Zip	:	43113-1087
Country	:	US
Telephone Number	:	740-497-2479
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	ELIZABETH BECKLEY
Credential	:
Telephone Number	:	740-571-2333

Provider Enumeration Date	:	07/30/2021
Last Update Date	:	08/18/2025

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