Provider Demographics
NPI:1316473275
Name:NORTHWEST OHIO CHRISTIAN COUNSELING, LTD
Entity type:Organization
Organization Name:NORTHWEST OHIO CHRISTIAN COUNSELING, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KINNERSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PCC
Authorized Official - Phone:419-724-7427
Mailing Address - Street 1:4041 W SYLVANIA AVE
Mailing Address - Street 2:STE LL2
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4465
Mailing Address - Country:US
Mailing Address - Phone:419-724-7427
Mailing Address - Fax:
Practice Address - Street 1:4041 W SYLVANIA AVE
Practice Address - Street 2:STE LL2
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4465
Practice Address - Country:US
Practice Address - Phone:419-724-7427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0007948101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1023229952OtherNPI