Healthcare Provider Details

I. General information

NPI: 1548199375
Provider Name (Legal Business Name): HIS & HER MINDSET WELLNESS COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 E MAIN ST
COLUMBUS OH
43205-2262
US

IV. Provider business mailing address

1890 E MAIN ST
COLUMBUS OH
43205-2262
US

V. Phone/Fax

Practice location:
  • Phone: 614-426-8855
  • Fax:
Mailing address:
  • Phone: 614-426-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: DEANDRA HARRISON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 614-426-8855