Connective Clinical Counseling

Organization Active NPI Adult Mental Health Clinic/Center · Syracuse, OH

NPI 1770158792 · NPPES record last updated May 21, 2021

Key facts

NPI
1770158792
Entity type
Organization (NPI type 2)
Primary specialty
Adult Mental Health Clinic/Center 261QM0850X
Legal business name
CONNECTIVE CLINICAL COUNSELING
Practice address
2377 Fourth Street
Syracuse, OH 45779
Phone
(740) 247-5463
NPI assigned
May 21, 2021
Organization subpart
No

Authorized official

Name
Trisha Gibson, MA, LPCC, LICDC
Title
Psychotherapist
Phone
(740) 247-5463

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Connective Clinical Counseling (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Yes

Addresses

Primary practice location

2377 Fourth Street
Syracuse, OH 45779

Mailing address

PO Box 134
Syracuse, OH 45779-0134
Phone (740) 247-5463

Other identifiers

IdentifierTypeStateIssuer
0439139MedicaidOH

Other names

  • Connective Clinical Counseling Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL counseling@connectiveclinical.sprucecare.com Direct

Other providers in Syracuse, OH

All providers in Syracuse, OH · Adult Mental Health Clinic/Center in Ohio

Sources for this page

Verify at the official NPI Registry.