Healthcare Provider Details

I. General information

NPI: 1225102940
Provider Name (Legal Business Name): DOUG WARNE MSW, LISW-S, LICDC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DOUGLAS D WARNE NSW, LISW-S, LICDC

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 PHALE D HALE DR
COLUMBUS OH
43203-1791
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-785-6523
  • Fax: 614-257-3148
Mailing address:
  • Phone: 614-785-6523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberDOT Q-SAP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number981021
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI 0007673
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: