Provider Demographics
NPI:1518359819
Name:OUTREACH AND CRISIS COUNSELING SERVICES
Entity Type:Organization
Organization Name:OUTREACH AND CRISIS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:BAYS
Authorized Official - Suffix:
Authorized Official - Credentials:LICDC
Authorized Official - Phone:614-352-2620
Mailing Address - Street 1:1547 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43222-1043
Mailing Address - Country:US
Mailing Address - Phone:614-352-2620
Mailing Address - Fax:614-675-2577
Practice Address - Street 1:1547 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1043
Practice Address - Country:US
Practice Address - Phone:614-352-2620
Practice Address - Fax:614-675-2577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
OH121039261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251S00000XAgenciesCommunity/Behavioral Health