Organization
EDEN COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM EARL JENNINGS (CEO)
(614) 352-6993
Entity
Organization
Contact information
Practice address
8794 BIG BEAR AVE, POWELL, OH 43065
(614) 352-6993
Mailing address
134 NORTHWOODS BLVD STE B1, COLUMBUS, OH 43235-4727
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
34.010652
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
35.071312
OH
101YM0800X
Mental Health Counselor
34.010652
OH
101YM0800X
Mental Health Counselor
35.071312
OH
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093890550
NPI
OH
01
—
1164759866
NPI
OH
01
—
1538251434
NPI
OH
01
—
1811144264
NPI
OH
Enumeration date
09/16/2015
Last updated
12/10/2015
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