Healthcare Provider Details

I. General information

NPI: 1023983012
Provider Name (Legal Business Name): ANANEO THERAPY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4449 EASTON WAY STE 2064
COLUMBUS OH
43219-6093
US

IV. Provider business mailing address

4449 EASTON WAY STE 2064
COLUMBUS OH
43219-6093
US

V. Phone/Fax

Practice location:
  • Phone: 614-321-7901
  • Fax:
Mailing address:
  • Phone: 614-321-7901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. TIVONA LEA BANKS
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: LPCC
Phone: 614-290-6633