PROFESSIONAL BEHAVIORAL SUPPORT LLC NPI 1174201545

NPI Information

  • NPI: 1174201545
  • Provider Name: PROFESSIONAL BEHAVIORAL SUPPORT LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Doing Business As: PROFESSIONAL BEHAVIORAL SUPPORT LLC
  • Address: 691 E DUBLIN GRANVILLE RD
    COLUMBUS, OH
    ZIP 43229
  • Phone: (614) 715-2154

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NPI Details

PROFESSIONAL BEHAVIORAL SUPPORT LLC is a mental health (including community mental health center) clinic center in Columbus, OH. PROFESSIONAL BEHAVIORAL SUPPORT LLC NPI is 1174201545. The provider is registered as an organization entity type.
The provider Is Doing Business As Professional Behavioral Support Llc.

The provider's business location address is:

691 E DUBLIN GRANVILLE RD
COLUMBUS, OH
ZIP 43229-209
Phone: (614) 715-2154
Fax: (614) 705-6577

The provider's authorized official is Elieth Kokwesiga Kamala .
The authorized official title is Pschiatric Nurse Practictitioner and has the following contact phone number (614) 574-1823.

The enumeration date for this NPI number is 7/6/2023 and was last updated on 12/9/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

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This page was last updated on: 3/30/2025

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