Healthcare Provider Details

I. General information

NPI: 1942113618
Provider Name (Legal Business Name): OHIO PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 LAKE SHORE DR STE 300
COLUMBUS OH
43204-2587
US

IV. Provider business mailing address

2722 ERIE AVE STE 219 PMB #813041
CINCINNATI OH
45208-2154
US

V. Phone/Fax

Practice location:
  • Phone: 614-673-3558
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: KRISHNA DEV VELLANKI
Title or Position: MANAGER
Credential: DO
Phone: 614-673-3558