| Common Bond Counseling, Llc | |
|
1220 W Hunter St Logan OH 43138-1012 | |
| (740) 205-2999 | |
| (740) 216-4501 |
| Full Name | Common Bond Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1220 W Hunter St, Logan, Ohio |
| Authorized Official Name and Position | Teresa Dement (SECRETARY) |
| Authorized Official Contact | 7409743206 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Common Bond Counseling, Llc 1220 W Hunter St Logan OH 43138-1012 Ph: (740) 205-2999 | Common Bond Counseling, Llc 1220 W Hunter St Logan OH 43138-1012 Ph: (740) 205-2999 |
| NPI Number | 1326542507 |
|---|---|
| Provider Enumeration Date | 03/21/2018 |
| Last Update Date | 03/21/2018 |
| Medicare PECOS PAC ID | 8022422096 |
|---|---|
| Medicare Enrollment ID | O20210202003347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326542507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Leslie Ann Burgie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902870405 PECOS PAC ID: 3375553795 Enrollment ID: I20060501000314 |
| Provider Name | Teresa S. Dement |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457890097 PECOS PAC ID: 9931513900 Enrollment ID: I20240201004150 |
| Provider Name | Guy Scott Taylor |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1497294052 PECOS PAC ID: 1759795727 Enrollment ID: I20240212003513 |
Psychiatric Consultants, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1216 W Hunter St, Logan, OH 43138 Phone: 740-300-2080 Fax: 614-522-6604 | |
Summit Recovery Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 549 E Front St, Logan, OH 43138 Phone: 740-279-9998 | |
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