Healthcare Provider Details

I. General information

NPI: 1538955513
Provider Name (Legal Business Name): TAROWYN AMBER SHIELDS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 NORTHWOODS BLVD STE C2
COLUMBUS OH
43235-4726
US

IV. Provider business mailing address

132 NORTHWOODS BLVD STE C2
COLUMBUS OH
43235-4726
US

V. Phone/Fax

Practice location:
  • Phone: 614-454-8443
  • Fax:
Mailing address:
  • Phone: 614-454-8443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2406240
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: