Organization
CONNECTIVE CLINICAL COUNSELING
Active
Other names
Connective Clinical Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
TRISHA GIBSON MA, LPCC, LICDC (PSYCHOTHERAPIST)
(740) 247-5463
Entity
Organization
Contact information
Practice address
2377 FOURTH STREET, SYRACUSE, OH 45779
(740) 247-5463
Mailing address
PO BOX 134, SYRACUSE, OH 45779-0134
(740) 247-5463
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0439139
—
OH
Enumeration date
05/21/2021
Last updated
05/21/2021
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