Healthcare Provider Details

I. General information

NPI: 1841071958
Provider Name (Legal Business Name): MR. LONDALE BERNARD TOWNS SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2023
Last Update Date: 10/13/2023
Certification Date: 10/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

996 OAKWOOD AVE
COLUMBUS OH
43206-1578
US

IV. Provider business mailing address

3960 KNAPFORD DR APT G
COLUMBUS OH
43230-7746
US

V. Phone/Fax

Practice location:
  • Phone: 614-252-7488
  • Fax:
Mailing address:
  • Phone: 614-946-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: