Healthcare Provider Details

I. General information

NPI: 1689507667
Provider Name (Legal Business Name): EXPERIENCES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2283 SUNBURY RD
COLUMBUS OH
43219-3528
US

IV. Provider business mailing address

3750 E BROAD ST UNIT 13056
COLUMBUS OH
43213-7003
US

V. Phone/Fax

Practice location:
  • Phone: 614-584-4498
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JASON D TERRELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 614-584-4498