| Connective Clinical Counseling, Llc | |
| 
					2377 Fourth Street Syracuse OH 45779  | |
| (740) 247-5463 | |
| (740) 212-8445 | 
| Full Name | Connective Clinical Counseling, Llc | 
|---|---|
| Speciality | Counselor - Mental Health | 
| Location | 2377 Fourth Street, Syracuse, Ohio | 
| Authorized Official Name and Position | Trisha Gibson (PSYCHOTHERAPIST/OWNER) | 
| Authorized Official Contact | 7402475463 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Connective Clinical Counseling, Llc Po Box 134 Syracuse OH 45779-0134 Ph: (740) 247-5463  | Connective Clinical Counseling, Llc 2377 Fourth Street Syracuse OH 45779 Ph: (740) 247-5463  | 
| NPI Number | 1710553110 | 
|---|---|
| Provider Enumeration Date | 05/27/2021 | 
| Last Update Date | 05/27/2021 | 
| Certification Date | 05/18/2021 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1710553110 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary | 
Connective Clinical Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2448 Third Street, Syracuse, OH 45779 Phone: 740-247-5463 Fax: 740-212-8445  | |
Connective Clinical Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2377 Fourth Street, Syracuse, OH 45779 Phone: 740-247-5463  |