Provider Demographics
NPI:1518453158
Name:PATRICIA RUPP HUNT LISW, LCC
Entity Type:Organization
Organization Name:PATRICIA RUPP HUNT LISW, LCC
Other - Org Name:OUTSIDE THE BARN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:RUPP
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:937-750-7877
Mailing Address - Street 1:15830 SCHOOLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-9716
Mailing Address - Country:US
Mailing Address - Phone:937-750-7877
Mailing Address - Fax:
Practice Address - Street 1:15830 SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309-9716
Practice Address - Country:US
Practice Address - Phone:937-750-7877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health