| Covenant Psychological And Consulting Services, Inc | |
|
7664 Slate Ridge Blvd Reynoldsburg OH 43068-8158 | |
| (614) 863-2399 | |
| Not Available |
| Full Name | Covenant Psychological And Consulting Services, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7664 Slate Ridge Blvd, Reynoldsburg, Ohio |
| Authorized Official Name and Position | John J Wagner (PRESIDENT) |
| Authorized Official Contact | 6148632399 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Psychological And Consulting Services, Inc 7664 Slate Ridge Blvd Reynoldsburg OH 43068-8158 Ph: (614) 863-2399 | Covenant Psychological And Consulting Services, Inc 7664 Slate Ridge Blvd Reynoldsburg OH 43068-8158 Ph: (614) 863-2399 |
| NPI Number | 1972860070 |
|---|---|
| Provider Enumeration Date | 04/13/2012 |
| Last Update Date | 04/13/2012 |
| Medicare PECOS PAC ID | 3173755071 |
|---|---|
| Medicare Enrollment ID | O20140408000857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972860070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5746 (Ohio) | Primary |
| Provider Name | John J Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700801487 PECOS PAC ID: 7911900097 Enrollment ID: I20070912000740 |
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