1063782902 NPI number — TURNING POINT PSYCHOTHERAPY AND ASSESSMENT, LLC

Table of content: (NPI 1063782902)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063782902 NPI number — TURNING POINT PSYCHOTHERAPY AND ASSESSMENT, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TURNING POINT PSYCHOTHERAPY AND ASSESSMENT, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063782902
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
TURNING POINT PSYCHOTHERAPY AND ASSESSMENT, LLC
Provider Second Line Business Mailing Address:
1125 RALSTON AVE.
Provider Business Mailing Address City Name:
DEFIANCE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43512-1336
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-782-2800
Provider Business Mailing Address Fax Number:
419-782-2805

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TURNING POINT PSYCHOTHERAPY AND ASSESSMENT, LLC
Provider Second Line Business Practice Location Address:
1125 RALSTON AVE.
Provider Business Practice Location Address City Name:
DEFIANCE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43512-1336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-782-2800
Provider Business Practice Location Address Fax Number:
419-782-2805
Provider Enumeration Date:
01/10/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DAVIES
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
419-782-2800

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  6128 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)