Healthcare Provider Details

I. General information

NPI: 1083463806
Provider Name (Legal Business Name): LIFEWORKS OF OHIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 06/19/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 AIRPORT DR
COLUMBUS OH
43219-2286
US

IV. Provider business mailing address

2720 AIRPORT DR
COLUMBUS OH
43219-2219
US

V. Phone/Fax

Practice location:
  • Phone: 614-900-4698
  • Fax:
Mailing address:
  • Phone: 614-599-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: SAID ISSE
Title or Position: CEO
Credential:
Phone: 614-900-4698