Provider Demographics
NPI:1679188536
Name:SEA GLASS COUNSELING AND CONSULTATION, LLC
Entity Type:Organization
Organization Name:SEA GLASS COUNSELING AND CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:PRITCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC-S
Authorized Official - Phone:614-746-5926
Mailing Address - Street 1:545 METRO PL S STE 100
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5353
Mailing Address - Country:US
Mailing Address - Phone:614-398-0558
Mailing Address - Fax:614-234-2935
Practice Address - Street 1:545 METRO PL S STE 100
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5353
Practice Address - Country:US
Practice Address - Phone:614-398-0558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty