Provider Demographics
NPI:1255879557
Name:CARTER LOGAN, ABBEY (LPCC-S)
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:
Last Name:CARTER LOGAN
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 ALDRICH RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2554
Mailing Address - Country:US
Mailing Address - Phone:614-893-1205
Mailing Address - Fax:
Practice Address - Street 1:5354 N HIGH ST STE 206
Practice Address - Street 2:CLINTONVILLE COUNSELING AND WELLNESS
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1274
Practice Address - Country:US
Practice Address - Phone:614-948-7300
Practice Address - Fax:614-948-7300
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0800149-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional