Provider Demographics
NPI:1619376936
Name:OHIO TREATMENT AND COUNSELING CENTER
Entity Type:Organization
Organization Name:OHIO TREATMENT AND COUNSELING CENTER
Other - Org Name:CINCINNATI TREATMENT AND COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PRABODH
Authorized Official - Middle Name:
Authorized Official - Last Name:VAIDYA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:312-399-8243
Mailing Address - Street 1:3041 SYMMES RD STE D
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45015-1383
Mailing Address - Country:US
Mailing Address - Phone:513-860-9888
Mailing Address - Fax:513-860-2268
Practice Address - Street 1:3041 SYMMES RD STE D
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45015-1383
Practice Address - Country:US
Practice Address - Phone:513-860-9888
Practice Address - Fax:513-860-2268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty