Provider Type Icon

MAUMEE VALLEY GUIDANCE CENTER NPI 1639341589


NPI Information

NPI: 1639341589
Provider Name: MAUMEE VALLEY GUIDANCE CENTER
Classification: Psychologist - 103TP0016X
Entity Type: Organization

Specialization: Prescribing (Medical)

CLIA Number: 36D1053301

Address:
211 BIEDE AVE
DEFIANCE, OH
ZIP 43512
Phone: (419) 782-8856
Get Directions

MAUMEE VALLEY GUIDANCE CENTER is a prescribing (medical) psychologist in Defiance, OH. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. MAUMEE VALLEY GUIDANCE CENTER NPI is 1639341589. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

211 BIEDE AVE
DEFIANCE, OH
ZIP 43512-408
Phone: (419) 782-8856
Fax: (419) 782-2261

The provider's authorized official is Mary Bailey .
The authorized official title is Cfo and has the following contact phone number (419) 782-8856.

The CLIA number assigned to this NPI record is 36D1053301 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/1/2008 and was last updated on 4/1/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TP0016XPsychologistPrescribing (Medical)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10304807MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.