Provider Demographics
NPI:1326542507
Name:COMMON BOND COUNSELING, LLC
Entity Type:Organization
Organization Name:COMMON BOND COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CDCA
Authorized Official - Phone:740-974-3206
Mailing Address - Street 1:1220 W HUNTER ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-1012
Mailing Address - Country:US
Mailing Address - Phone:740-205-2999
Mailing Address - Fax:740-216-4501
Practice Address - Street 1:1220 W HUNTER ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-1012
Practice Address - Country:US
Practice Address - Phone:740-205-2999
Practice Address - Fax:740-216-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty