Provider Demographics
NPI:1255901146
Name:DWELLING PLACE COUNSELING LLC
Entity type:Organization
Organization Name:DWELLING PLACE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER/ CREDENTIALLER
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-360-8434
Mailing Address - Street 1:1075 BEECHER CROSSING NORTH
Mailing Address - Street 2:SUITE C
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4572
Mailing Address - Country:US
Mailing Address - Phone:614-423-9310
Mailing Address - Fax:937-606-3077
Practice Address - Street 1:1075 BEECHER CROSSING NORTH
Practice Address - Street 2:SUITE C
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-4572
Practice Address - Country:US
Practice Address - Phone:614-423-9310
Practice Address - Fax:937-606-3077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty