Provider Demographics
NPI:1699585216
Name:VARCHULIK, MICHAEL (PRS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:VARCHULIK
Suffix:
Gender:M
Credentials:PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 W CENTER ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-3669
Mailing Address - Country:US
Mailing Address - Phone:220-228-4255
Mailing Address - Fax:
Practice Address - Street 1:1271 CRESCENT HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6455
Practice Address - Country:US
Practice Address - Phone:740-692-9442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.005929101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)