Healthcare Provider Details

I. General information

NPI: 1285547307
Provider Name (Legal Business Name): NATIONWIDE CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 BUTTERFLY GARDENS DR STE 2A
COLUMBUS OH
43215-3427
US

IV. Provider business mailing address

5265 FRISCO DR
HILLIARD OH
43026-8925
US

V. Phone/Fax

Practice location:
  • Phone: 614-355-8695
  • Fax: 614-355-8620
Mailing address:
  • Phone: 440-867-8164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: GRACE LARA DAKWAR
Title or Position: OUTPATIENT ACUTE THERAPIST
Credential: LPC
Phone: 614-938-0180