1639470495 NPI number — SECOND COMMUNITY HEALTH FAMILY COUNSELING EDUCATION CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639470495 NPI number — SECOND COMMUNITY HEALTH FAMILY COUNSELING EDUCATION CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SECOND COMMUNITY HEALTH FAMILY COUNSELING EDUCATION CENTER
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:
1639470495
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3284 N BEND RD
Provider Second Line Business Mailing Address:
SUITE 312 B
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45239-7688
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-481-2432
Provider Business Mailing Address Fax Number:
513-662-2432

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3284 N BEND RD
Provider Second Line Business Practice Location Address:
SUITE 312 B
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45239-7688
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-481-2432
Provider Business Practice Location Address Fax Number:
513-662-2432
Provider Enumeration Date:
11/10/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HANLEY
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
LICENSED INDEPENDENT SOCIAL WORKER
Authorized Official Telephone Number:
513-481-2432

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  I 0003334 , 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)





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