Healthcare Provider Details

I. General information

NPI: 1912722372
Provider Name (Legal Business Name): ARC AUTISM SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 COUNTRY CLUB RD UNIT A
COLUMBUS OH
43213-2484
US

IV. Provider business mailing address

1021 COUNTRY CLUB RD UNIT A
COLUMBUS OH
43213-2484
US

V. Phone/Fax

Practice location:
  • Phone: 614-407-3572
  • Fax: 614-340-2922
Mailing address:
  • Phone: 614-407-3572
  • Fax: 614-340-2922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: AMANDA SMITH
Title or Position: CHIEF SERVICES OFFICER
Credential:
Phone: 614-479-2513