Healthcare Provider Details

I. General information

NPI: 1477863165
Provider Name (Legal Business Name): INNER-CIRCLE COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3246 NOE BIXBY RD STE 111
COLUMBUS OH
43232-6361
US

IV. Provider business mailing address

1803 BOSTWICK RD
COLUMBUS OH
43227-3368
US

V. Phone/Fax

Practice location:
  • Phone: 614-470-4517
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ANTONIO L TRAVIS
Title or Position: CEO
Credential:
Phone: 614-517-6272