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NPI Code Detail

MEDICARE: NORTH COMMUNITY COUNSELING CTRS INC

MEDICARE: NORTH COMMUNITY COUNSELING CTRS INC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3103TC2200XClinical Child & Adolescent Psychologist
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831182922
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH COMMUNITY COUNSELING CTRS INC
Provider Business Mailing Address
First Line : 4897 KARL RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-5147
Country : US
Telephone Number : 614-269-7003
Fax Number : 614-267-7013
Provider Business Practice Location Address
First Line : 2300 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-3783
Country : US
Telephone Number : 614-279-7690
Fax Number : 614-279-7695
Authorized Official
Title or Position : PRESIDENT
Name : DAVID B KITTREDGE
Credential :
Telephone Number : 614-237-7003
Provider Enumeration Date : 08/24/2005
Last Update Date : 05/17/2012

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Directions to “NORTH COMMUNITY COUNSELING CTRS INC ” Practice Location

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