Provider Demographics
NPI:1679844526
Name:SOUTHEASTERN OHIO COUNSELING CENTER, LLC.
Entity type:Organization
Organization Name:SOUTHEASTERN OHIO COUNSELING CENTER, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCGLUMPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW-S
Authorized Official - Phone:740-260-9440
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:OLD WASHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43768-0094
Mailing Address - Country:US
Mailing Address - Phone:740-260-9440
Mailing Address - Fax:740-432-4940
Practice Address - Street 1:239A OLD NATIONAL RD
Practice Address - Street 2:
Practice Address - City:OLD WASHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43768
Practice Address - Country:US
Practice Address - Phone:740-489-5571
Practice Address - Fax:740-489-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI050001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health