Basic Information
| Provider Information | |||||||||
| NPI: | 1952434235 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRIESS | ||||||||
| FirstName: | BURTON | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | CHILDREN'S HOSPITAL GUIDANCE CENTER | ||||||||
| Address2: | 899 E. BROAD ST 3RD FLOOR | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143558000 | ||||||||
| FaxNumber: | 6143558018 | ||||||||
| Practice Location | |||||||||
| Address1: | CHILDREN'S HOSPITAL GUIDANCE CENTER | ||||||||
| Address2: | 899 E. BROAD ST 3RD FLOOR | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143558000 | ||||||||
| FaxNumber: | 6143558018 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | C0007338 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.