Healthcare Provider Details

I. General information

NPI: 1073421640
Provider Name (Legal Business Name): EVERLY PSYCHOLOGICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 EASTON OVAL STE 220
COLUMBUS OH
43219-6011
US

IV. Provider business mailing address

3 EASTON OVAL STE 220
COLUMBUS OH
43219-6011
US

V. Phone/Fax

Practice location:
  • Phone: 614-233-1960
  • Fax: 614-633-1649
Mailing address:
  • Phone: 614-233-1960
  • Fax: 614-633-1649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA KING BAILEY
Title or Position: OWNER
Credential: PSY.D
Phone: 614-233-1960