Healthcare Provider Details

I. General information

NPI: 1710851001
Provider Name (Legal Business Name): PROMYSE DRAPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 E LONG ST
COLUMBUS OH
43215-2915
US

IV. Provider business mailing address

4863 SAW GROVE CT
GROVEPORT OH
43125-9380
US

V. Phone/Fax

Practice location:
  • Phone: 614-330-9828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2507467
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: