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Organization
CENTER STREET COMMUNITY CLINIC, INC
Active
Organization
CENTER STREET COMMUNITY CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY COBB (CFO)
(740) 751-4531
Entity
Organization
Contact information
Practice address
125 EXECUTIVE DR STE 201, MARION, OH 43302-6302
(740) 387-3087
Mailing address
136 W CENTER ST, MARION, OH 43302-3704
(740) 751-4531
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/13/2023
Last updated
08/03/2026
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