Provider Demographics
NPI:1558436543
Name:CINCINNATI RELATIONSHIP CENTER INC
Entity Type:Organization
Organization Name:CINCINNATI RELATIONSHIP CENTER INC
Other - Org Name:J THOMAS DEVOGE PHD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:DEVOGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-794-9144
Mailing Address - Street 1:8315 MONTGOMERY ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2227
Mailing Address - Country:US
Mailing Address - Phone:513-794-9144
Mailing Address - Fax:513-794-1083
Practice Address - Street 1:8315 MONTGOMERY ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2227
Practice Address - Country:US
Practice Address - Phone:513-794-9144
Practice Address - Fax:513-794-1083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH832103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000030185ZOtherANTHEM BCBS
232722014004OtherMEDICAL MUTUAL
=========00OtherWORKMANS COMPENSATION
232722014004OtherMEDICAL MUTUAL
DECP06701Medicare UPIN