Provider Demographics
NPI:1083773204
Name:PROFESSIONAL PASTORAL- COUNSELING INST. INC.
Entity Type:Organization
Organization Name:PROFESSIONAL PASTORAL- COUNSELING INST. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DONNENWIRTH
Authorized Official - Suffix:
Authorized Official - Credentials:PCC
Authorized Official - Phone:513-791-5990
Mailing Address - Street 1:8035 HOSBROOK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2951
Mailing Address - Country:US
Mailing Address - Phone:513-791-5990
Mailing Address - Fax:513-792-3308
Practice Address - Street 1:8035 HOSBROOK RD STE 300
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2951
Practice Address - Country:US
Practice Address - Phone:513-791-5990
Practice Address - Fax:513-792-3308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE3055101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty