| Family Counseling & Rehabilitation Center Of Ohio | |
|
121 Putnam St Marietta OH 45750-2926 | |
| (740) 249-8061 | |
| Not Available |
| Full Name | Family Counseling & Rehabilitation Center Of Ohio |
|---|---|
| Speciality | Counselor |
| Location | 121 Putnam St, Marietta, Ohio |
| Authorized Official Name and Position | Jennifer Ann Simmons (OWNER) |
| Authorized Official Contact | 7402498061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Counseling & Rehabilitation Center Of Ohio Po Box 462 Belpre OH 45714-0462 Ph: (740) 249-8061 | Family Counseling & Rehabilitation Center Of Ohio 121 Putnam St Marietta OH 45750-2926 Ph: (740) 249-8061 |
| NPI Number | 1528605276 |
|---|---|
| Provider Enumeration Date | 12/02/2019 |
| Last Update Date | 06/02/2021 |
| Certification Date | 06/02/2021 |
| Medicare PECOS PAC ID | 3476979592 |
|---|---|
| Medicare Enrollment ID | O20210806000882 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528605276 | NPI | - | NPPES |
| Provider Name | Raymond Bruce Henthorn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720083066 PECOS PAC ID: 0446235766 Enrollment ID: I20040621002016 |
| Provider Name | Gary S Stofle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053480970 PECOS PAC ID: 4789638636 Enrollment ID: I20050303000793 |
| Provider Name | Danyelle R Brooker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962082602 PECOS PAC ID: 7719372549 Enrollment ID: I20220315000467 |
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