Organization
INTACT COUNSELING GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE GENTILE EDELMANN MA, LPCC, CSAT (PARTNER)
(513) 602-2740
Entity
Organization
Contact information
Practice address
9200 MONTGOMERY RD STE 15B, CINCINNATI, OH 45242-7730
(513) 602-2740
Mailing address
9200 MONTGOMERY RD BLDG D, SUIT 15B, CINCINNATI, OH 45242-7789
(513) 602-2740
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
E100187
OH
101YP2500X
Professional Counselor
C0501191
OH
101YP2500X
Professional Counselor
Primary
E1100187
OH
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851833115
PERSONAL NPI
OH
Enumeration date
08/02/2017
Last updated
08/02/2017
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