Healthcare Provider Details

I. General information

NPI: 1649034406
Provider Name (Legal Business Name): MAKRIDIS LEARNING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 HAMPSHIRE RD
COLUMBUS OH
43209-2651
US

IV. Provider business mailing address

2920 HAMPSHIRE RD
COLUMBUS OH
43209-2651
US

V. Phone/Fax

Practice location:
  • Phone: 937-269-1679
  • Fax: 614-618-4907
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DIMITRIOS V. MAKRIDIS
Title or Position: OWNER
Credential:
Phone: 937-470-5092