Healthcare Provider Details

I. General information

NPI: 1811926512
Provider Name (Legal Business Name): JOHN M. SHOWALTER DBA CONSULTING PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1971 W 5TH AVE SUITE 2
COLUMBUS OH
43212-1905
US

IV. Provider business mailing address

1971 W 5TH AVE SUITE 2
COLUMBUS OH
43212-1905
US

V. Phone/Fax

Practice location:
  • Phone: 614-488-6285
  • Fax: 614-875-4121
Mailing address:
  • Phone: 614-488-6285
  • Fax: 614-875-4121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JOHN M SHOWALTER
Title or Position: OWNER
Credential: PH.D
Phone: 614-488-6285