Provider Demographics
NPI:1902185614
Name:CENTRAL OHIO BEHAVIORAL CONSULTING, LLC
Entity Type:Organization
Organization Name:CENTRAL OHIO BEHAVIORAL CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR, BEHAVIOR CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEIGH ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:614-582-5634
Mailing Address - Street 1:PO BOX 915
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-0915
Mailing Address - Country:US
Mailing Address - Phone:614-582-5634
Mailing Address - Fax:
Practice Address - Street 1:20135 STATE ROUTE 245
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9114
Practice Address - Country:US
Practice Address - Phone:614-582-5634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management