Healthcare Provider Details

I. General information

NPI: 1699611681
Provider Name (Legal Business Name): JESSICA M PACE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 PARSONS AVE
COLUMBUS OH
43207-3883
US

IV. Provider business mailing address

4634 GRANDOVER DR
COLUMBUS OH
43207-8763
US

V. Phone/Fax

Practice location:
  • Phone: 614-556-5779
  • Fax:
Mailing address:
  • Phone: 614-556-5779
  • 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:
Title or Position:
Credential:
Phone: