Healthcare Provider Details

I. General information

NPI: 1144183831
Provider Name (Legal Business Name): REEKU BARAILI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 W BROAD ST STE 200
COLUMBUS OH
43222-1465
US

IV. Provider business mailing address

815 W BROAD ST STE 200
COLUMBUS OH
43222-1465
US

V. Phone/Fax

Practice location:
  • Phone: 614-717-0822
  • Fax:
Mailing address:
  • Phone: 614-717-0822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCAPRE.195144
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.006127
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: