Organization
CENTRAL CLINIC OUTPATIENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY G MAGES PH.D., LPCC (PRESIDENT/CEO)
(513) 558-5879
Entity
Organization
Contact information
Practice address
311 ALBERT SABIN WAY, CINCINNATI, OH 45229-2838
(513) 558-9005
(513) 558-3880
Mailing address
311 ALBERT SABIN WAY, CINCINNATI, OH 45229-2838
(513) 558-9005
(513) 558-3880
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0216264
—
OH
Enumeration date
03/27/2017
Last updated
02/22/2024
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