Provider Demographics
NPI:1831182922
Name:NORTH COMMUNITY COUNSELING CTRS INC
Entity type:Organization
Organization Name:NORTH COMMUNITY COUNSELING CTRS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:KITTREDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-237-7003
Mailing Address - Street 1:4897 KARL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-5147
Mailing Address - Country:US
Mailing Address - Phone:614-269-7003
Mailing Address - Fax:614-267-7013
Practice Address - Street 1:2300 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3783
Practice Address - Country:US
Practice Address - Phone:614-279-7690
Practice Address - Fax:614-279-7695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2499783Medicaid
OH2499783Medicaid
9933541Medicare ID - Type UnspecifiedMORSE RD LOCATION
9933542Medicare ID - Type UnspecifiedKARL RD OFFICE
9933543Medicare ID - Type UnspecifiedW BRAOD OFFICE