National Provider Identifier Database

CONNECTIVE CLINICAL COUNSELING
Adult Mental Health

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.


Contact Information

CONNECTIVE CLINICAL COUNSELING
2377 FOURTH STREET
SYRACUSE, OH45779
Phone: 740-247-5463
Fax:
Website:
Specialty Taxonomy Code
* Adult Mental Health 261QM0850X

* Indicates primary specialty

NPI Profile & details for CONNECTIVE CLINICAL COUNSELING

NPI Number 1770158792
Legal business name
LBN
CONNECTIVE CLINICAL COUNSELING
Authorized official TRISHA GIBSON - (PSYCHOTHERAPIST)
Entity Organization
Organization subpart No
Enumeration date 05/21/2021
Last updated 05/21/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • OH Medicaid: 0439139

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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