Healthcare Provider Details

I. General information

NPI: 1700511532
Provider Name (Legal Business Name): KATELYN DELEON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATELYN DELEON QMHS

II. Dates (important events)

Enumeration Date: 07/16/2022
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 E BROAD ST
COLUMBUS OH
43205-1156
US

IV. Provider business mailing address

6069 LAKE CLUB PL
COLUMBUS OH
43232-3156
US

V. Phone/Fax

Practice location:
  • Phone: 614-396-9333
  • Fax: 614-396-9331
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: