Healthcare Provider Details

I. General information

NPI: 1942861513
Provider Name (Legal Business Name): ANNE DUDLEY-MARLING LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 06/18/2020
Certification Date: 06/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 S HIGH ST STE 220
COLUMBUS OH
43215-5644
US

IV. Provider business mailing address

228 LANSING ST
COLUMBUS OH
43206-2615
US

V. Phone/Fax

Practice location:
  • Phone: 614-625-7183
  • Fax:
Mailing address:
  • Phone: 781-572-1382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.1801530
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1801530
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: