Provider Demographics
NPI:1356327308
Name:PSYCHOTHERAPY & ADDICTION SRVCS., INC.
Entity Type:Organization
Organization Name:PSYCHOTHERAPY & ADDICTION SRVCS., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOWDER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, CCDC, III E
Authorized Official - Phone:937-435-5200
Mailing Address - Street 1:7086 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4224
Mailing Address - Country:US
Mailing Address - Phone:937-435-5200
Mailing Address - Fax:937-435-5200
Practice Address - Street 1:7086 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4224
Practice Address - Country:US
Practice Address - Phone:937-435-5200
Practice Address - Fax:937-435-5200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0000363101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000016169OtherANTHEM
OH0000073621OtherMANAGED HEALTH NETWORK
OH180942OtherVALUE OPTIONS
OH7379058OtherAETNA
OH520502648000OtherMEDICAL MUTUAL OF OH