State of Ohio

Organization Active NPI Community/Behavioral Health Agency · London, OH

NPI 1902218779 · NPPES record last updated May 28, 2014

Key facts

NPI
1902218779
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
6854 (OH)
Legal business name
STATE OF OHIO
Practice address
1580 State Route 56 SW
London Correctional Institution
London, OH 43140-8623
Phone
(740) 852-2454
NPI assigned
May 28, 2014
Organization subpart
No

Authorized official

Name
Princess Cripe, PSY.D.
Title
Staff Psychologist
Phone
(740) 852-2454

Corporate family (same tax ID) 5

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

Practitioners 6

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
Portsmouth Receiving Ho (6 organizations share this tax ID)

Locations

1580 State Route 56 SW
London, OH 43140
Phone (740) 845-9777

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6854 OH Yes

Addresses

Primary practice location

1580 State Route 56 SW
London Correctional Institution
London, OH 43140-8623

Mailing address

1049 Seacove Cir
Apt. G
London, OH 43140-9134
Phone (740) 852-2454

Other providers in London, OH

All providers in London, OH · Community/Behavioral Health Agency in Ohio

Sources for this page

Verify at the official NPI Registry.