Provider Demographics
NPI:1154628535
Name:PEGGY A. HEMMER, DBA, HEART AND SOUL COUNSELING
Entity Type:Organization
Organization Name:PEGGY A. HEMMER, DBA, HEART AND SOUL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LLISW-S
Authorized Official - Phone:614-569-8205
Mailing Address - Street 1:168 DORCHESTER SQ S
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-7302
Mailing Address - Country:US
Mailing Address - Phone:614-569-8205
Mailing Address - Fax:614-567-2525
Practice Address - Street 1:168 DORCHESTER SQ S
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-7302
Practice Address - Country:US
Practice Address - Phone:614-569-8205
Practice Address - Fax:614-567-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-20
Last Update Date:2011-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-070333-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI-0700333-SUPVOtherOHIO COUNSELOR, SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS BOARD
OH11772239OtherCAQH