| Connective Clinical Counseling | |
|
2377 Fourth Street Syracuse OH 45779 | |
| (740) 247-5463 | |
| Not Available |
| Full Name | Connective Clinical Counseling |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2377 Fourth Street, Syracuse, Ohio |
| Authorized Official Name and Position | Trisha Gibson (PSYCHOTHERAPIST) |
| Authorized Official Contact | 7402475463 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Connective Clinical Counseling Po Box 134 Syracuse OH 45779-0134 Ph: (740) 247-5463 | Connective Clinical Counseling 2377 Fourth Street Syracuse OH 45779 Ph: (740) 247-5463 |
| NPI Number | 1770158792 |
|---|---|
| Provider Enumeration Date | 05/21/2021 |
| Last Update Date | 05/21/2021 |
| Certification Date | 05/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770158792 | NPI | - | NPPES |
| 0439139 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Connective Clinical Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2448 Third Street, Syracuse, OH 45779 Phone: 740-247-5463 Fax: 740-212-8445 | |
Connective Clinical Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2377 Fourth Street, Syracuse, OH 45779 Phone: 740-247-5463 Fax: 740-212-8445 |