Provider Demographics
NPI:1104503135
Name:HIS STRENGTH CHRISTIAN COUNSELING LLC
Entity type:Organization
Organization Name:HIS STRENGTH CHRISTIAN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LSW, LPCC-S
Authorized Official - Phone:937-750-5700
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43083-0085
Mailing Address - Country:US
Mailing Address - Phone:937-875-6795
Mailing Address - Fax:
Practice Address - Street 1:4194 W US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-9663
Practice Address - Country:US
Practice Address - Phone:937-875-6795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty