Healthcare Provider Details

I. General information

NPI: 1194208512
Provider Name (Legal Business Name): MR. CHRISTOPHER FEATHERSTONE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 E BROAD ST STE 400
COLUMBUS OH
43213-2979
US

IV. Provider business mailing address

5117 BIXFORD AVE
CANAL WINCHESTER OH
43110-8606
US

V. Phone/Fax

Practice location:
  • Phone: 614-655-3345
  • Fax:
Mailing address:
  • Phone: 614-706-0141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: