Healthcare Provider Details

I. General information

NPI: 1689599839
Provider Name (Legal Business Name): AMY MORENO COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 VARSITY AVE
COLUMBUS OH
43221-1668
US

IV. Provider business mailing address

918 VARSITY AVE
COLUMBUS OH
43221-1668
US

V. Phone/Fax

Practice location:
  • Phone: 614-349-6626
  • Fax:
Mailing address:
  • Phone: 614-349-6626
  • 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: AMY MORENO
Title or Position: LICENSED COUNSELOR
Credential: LPCC-S
Phone: 614-349-6626