Healthcare Provider Details

I. General information

NPI: 1881425734
Provider Name (Legal Business Name): WITH THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 S WALL ST
COLUMBUS OH
43206-1921
US

IV. Provider business mailing address

726 REINHARD AVE
COLUMBUS OH
43206-2940
US

V. Phone/Fax

Practice location:
  • Phone: 216-965-5363
  • Fax:
Mailing address:
  • Phone: 216-965-5363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: QUANISHIA ARIANN GIBSON
Title or Position: OWNER
Credential:
Phone: 216-965-5363