Provider Demographics
NPI:1821382078
Name:METAMORPHOSIS COUNSELING & CONSULTING LLC
Entity Type:Organization
Organization Name:METAMORPHOSIS COUNSELING & CONSULTING LLC
Other - Org Name:DARRIN PETERSON
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA MED, LPCC-S
Authorized Official - Phone:614-300-3015
Mailing Address - Street 1:2020 BRICE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3448
Mailing Address - Country:US
Mailing Address - Phone:614-300-3015
Mailing Address - Fax:614-344-7548
Practice Address - Street 1:2020 BRICE RD STE 110
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3448
Practice Address - Country:US
Practice Address - Phone:614-300-3015
Practice Address - Fax:614-344-7548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2023-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0700886101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty