Provider Demographics
NPI:1164664496
Name:INTEGRITY PSYCHOLOGICAL COUNSELING LLC
Entity Type:Organization
Organization Name:INTEGRITY PSYCHOLOGICAL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:VASILAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:740-689-8910
Mailing Address - Street 1:42 HILL RD S
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-2240
Mailing Address - Country:US
Mailing Address - Phone:740-689-8910
Mailing Address - Fax:740-653-9252
Practice Address - Street 1:42 HILL RD S
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-2240
Practice Address - Country:US
Practice Address - Phone:740-689-8910
Practice Address - Fax:740-653-9252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5015739101YP2500X
OH5481103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000502434OtherBUREAU OF WORKERS' COMPENSATION