Healthcare Provider Details

I. General information

NPI: 1598429771
Provider Name (Legal Business Name): JOHN WATKINS MOHN IV LSW, LCDCIII
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 PARSONS AVE
COLUMBUS OH
43215-5331
US

IV. Provider business mailing address

240 PARSONS AVE
COLUMBUS OH
43215-5331
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-7417
  • Fax:
Mailing address:
  • Phone: 614-645-7417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS.2613761
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2613761
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.163027
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: