Provider Demographics
NPI:1992356356
Name:CENTER FOR TRAUMA THERAPY AND COUNSELING
Entity type:Organization
Organization Name:CENTER FOR TRAUMA THERAPY AND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GINGERICH
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:937-844-3927
Mailing Address - Street 1:1112 OMAHA RD
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-2355
Mailing Address - Country:US
Mailing Address - Phone:937-844-3927
Mailing Address - Fax:
Practice Address - Street 1:8200 STATE ROUTE 366
Practice Address - Street 2:
Practice Address - City:RUSSELLS POINT
Practice Address - State:OH
Practice Address - Zip Code:43348-9670
Practice Address - Country:US
Practice Address - Phone:937-844-3927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty