Provider Demographics
NPI:1184693103
Name:CAMBRIDGE COUNSELING CENTER, INC.
Entity type:Organization
Organization Name:CAMBRIDGE COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-435-9766
Mailing Address - Street 1:317 HIGHLAND AVE
Mailing Address - Street 2:PO BOX 1295
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-2529
Mailing Address - Country:US
Mailing Address - Phone:740-435-9766
Mailing Address - Fax:
Practice Address - Street 1:317 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2529
Practice Address - Country:US
Practice Address - Phone:740-435-9766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10685Medicaid
OHCA9320321Medicare ID - Type UnspecifiedGROUP NUMBER
OHCOSW24521Medicare PIN