| Kidsheart Counseling, Llc | |
|
463 Allenby Dr Marysville OH 43040-8521 | |
| (937) 209-0088 | |
| Not Available |
| Full Name | Kidsheart Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 463 Allenby Dr, Marysville, Ohio |
| Authorized Official Name and Position | Charity A Detrick (OWNER) |
| Authorized Official Contact | 9372090088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidsheart Counseling, Llc 1175 Brookstone Dr Marysville OH 43040-8743 Ph: (937) 642-3241 | Kidsheart Counseling, Llc 463 Allenby Dr Marysville OH 43040-8521 Ph: (937) 209-0088 |
| NPI Number | 1467965335 |
|---|---|
| Provider Enumeration Date | 11/14/2017 |
| Last Update Date | 11/14/2017 |
| Medicare PECOS PAC ID | 4183981129 |
|---|---|
| Medicare Enrollment ID | O20171130000791 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467965335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I.0008990 (Ohio) | Primary |
| Provider Name | Charity A Detrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326019134 PECOS PAC ID: 4880613801 Enrollment ID: I20051117001073 |
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