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Organization

ELLICE PARK LLC DBA COUNSELING CARE CIRCLE

Active
Other names
Ellice Park LLC
Organization subpart
No

Provider details

NPI number
Authorized official
VIRTUAL MUSTARD SEED (AGENT)
(614) 568-3233
Entity
Organization

Contact information

Practice address
180 E BROAD ST, COLUMBUS, OH 43215-3707
(614) 568-3233
Mailing address
PO BOX 2465, HARRISBURG, PA 17105-2465
(614) 568-3233

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YP1600X
Pastoral Counselor
101YP2500X
Professional Counselor
101YS0200X
School Counselor
102L00000X
Psychoanalyst
103T00000X
Psychologist
104100000X
Social Worker
106S00000X
Behavior Technician
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
Primary
282J00000X
Religious Nonmedical Health Care Institution
374K00000X
Religious Nonmedical Practitioner

Other

Enumeration date
09/03/2021
Last updated
05/09/2026
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