Provider Demographics
NPI:1578155743
Name:SAMBECKI COUNSELING & CONSULTATION
Entity Type:Organization
Organization Name:SAMBECKI COUNSELING & CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMBECKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:614-398-2041
Mailing Address - Street 1:475 OLDE IRISH DR
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8200
Mailing Address - Country:US
Mailing Address - Phone:901-233-8472
Mailing Address - Fax:
Practice Address - Street 1:2029 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-4057
Practice Address - Country:US
Practice Address - Phone:614-398-2041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0368642Medicaid