Healthcare Provider Details

I. General information

NPI: 1245182328
Provider Name (Legal Business Name): JENNIFER TYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENN TYE

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

881 E MAIN ST
COLUMBUS OH
43205-1713
US

IV. Provider business mailing address

881 E MAIN ST
COLUMBUS OH
43205-1713
US

V. Phone/Fax

Practice location:
  • Phone: 513-767-1808
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: