1740553163 NPI number — THE DENNIS COUNSELING GROUP LLC

Table of content: (NPI 1740553163)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740553163 NPI number — THE DENNIS COUNSELING GROUP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE DENNIS COUNSELING GROUP 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:
1740553163
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4424 CARVER WOODS DR STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLUE ASH
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45242-5535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-445-8445
Provider Business Mailing Address Fax Number:
513-536-6007

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4424 CARVER WOODS DR STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLUE ASH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45242-5535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-445-8445
Provider Business Practice Location Address Fax Number:
513-536-6007
Provider Enumeration Date:
02/15/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DENNIS
Authorized Official First Name:
CELESTE
Authorized Official Middle Name:
V
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
513-445-8445

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  001428 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: E-0003486 , 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)