Provider Demographics
NPI:1457664567
Name:PREFERRED CARE COUNSELING LLC
Entity Type:Organization
Organization Name:PREFERRED CARE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HUMPHRIES
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:330-757-3975
Mailing Address - Street 1:3292 STONES THROW AVE
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-4213
Mailing Address - Country:US
Mailing Address - Phone:330-757-3975
Mailing Address - Fax:330-757-3976
Practice Address - Street 1:3292 STONES THROW AVE
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-4213
Practice Address - Country:US
Practice Address - Phone:330-757-3975
Practice Address - Fax:330-757-3976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-17
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2713251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health