Provider Demographics
NPI:1265817100
Name:WAYBRIDGE COUNSELING SERVICES
Entity Type:Organization
Organization Name:WAYBRIDGE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BUTCH
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSEY
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, PCC-S
Authorized Official - Phone:513-688-0092
Mailing Address - Street 1:4030 MOUNT CARMEL TOBASCO RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3400
Mailing Address - Country:US
Mailing Address - Phone:513-688-0092
Mailing Address - Fax:
Practice Address - Street 1:4030 MOUNT CARMEL TOBASCO RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3400
Practice Address - Country:US
Practice Address - Phone:513-688-0092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health