Provider Demographics
NPI:1356631246
Name:SENECA COUNSELING AND PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:SENECA COUNSELING AND PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:CRUIKSHANKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:866-936-8559
Mailing Address - Street 1:PO BOX 1195
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-7195
Mailing Address - Country:US
Mailing Address - Phone:866-936-8559
Mailing Address - Fax:866-936-8559
Practice Address - Street 1:120 S WASHINGTON ST
Practice Address - Street 2:SUITE 209
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2840
Practice Address - Country:US
Practice Address - Phone:866-936-8559
Practice Address - Fax:866-936-8559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0003431-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty