Healthcare Provider Details

I. General information

NPI: 1982116091
Provider Name (Legal Business Name): HEATHER NICHOLE BRUNO LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4715 HILTON CORPORATE DR
COLUMBUS OH
43232-4152
US

IV. Provider business mailing address

4715 HILTON CORPORATE DR
COLUMBUS OH
43232-4152
US

V. Phone/Fax

Practice location:
  • Phone: 614-647-2000
  • Fax: 647-647-2000
Mailing address:
  • Phone: 614-647-2000
  • Fax: 614-647-2222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1700404-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: