Provider Demographics
NPI:1649417312
Name:AFRICAN PARISH HOUSE URBAN MINISTRIES
Entity Type:Organization
Organization Name:AFRICAN PARISH HOUSE URBAN MINISTRIES
Other - Org Name:HAVE FAITH CHRISTIAN COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:WM.-AMANZE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PINCKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV, LICDC, SAP
Authorized Official - Phone:614-258-4496
Mailing Address - Street 1:PO BOX 91132
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-7132
Mailing Address - Country:US
Mailing Address - Phone:614-258-4496
Mailing Address - Fax:
Practice Address - Street 1:189 N 20TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1550
Practice Address - Country:US
Practice Address - Phone:614-258-4496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH944092101YA0400X
OH081249101YA0400X
OHC0700473101YP2500X
OH1858103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0298637Medicaid
OHAF9359231Medicare PIN