Provider Demographics
NPI:1053941237
Name:OHIO FAMILY COUNSELING AND CONSULTATION, LLC
Entity type:Organization
Organization Name:OHIO FAMILY COUNSELING AND CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FEHRMAN RIDENBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:740-291-3737
Mailing Address - Street 1:PO BOX 1311
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-6311
Mailing Address - Country:US
Mailing Address - Phone:740-291-3737
Mailing Address - Fax:833-805-3653
Practice Address - Street 1:550 MAIN ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1612
Practice Address - Country:US
Practice Address - Phone:740-291-3737
Practice Address - Fax:833-805-3653
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO FAMILY COUNSELING AND CONSULTATION, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-16
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01-7804OtherOHIO DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES