Provider Demographics
NPI:1033695051
Name:SHAWNEE COUNSELING CENTER LLC
Entity type:Organization
Organization Name:SHAWNEE COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:STURGILL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:740-821-5084
Mailing Address - Street 1:741 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4001
Mailing Address - Country:US
Mailing Address - Phone:740-354-5562
Mailing Address - Fax:740-353-1275
Practice Address - Street 1:519 COURT ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3933
Practice Address - Country:US
Practice Address - Phone:740-876-4370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHAWNEE COUNSELING CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-12
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility