Healthcare Provider Details

I. General information

NPI: 1215864210
Provider Name (Legal Business Name): OLIVIA BERKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 E MAIN ST FL 3B
COLUMBUS OH
43215-5377
US

IV. Provider business mailing address

515 E MAIN ST FL 3B
COLUMBUS OH
43215-5377
US

V. Phone/Fax

Practice location:
  • Phone: 440-260-6835
  • Fax:
Mailing address:
  • Phone: 440-260-6835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: