Healthcare Provider Details

I. General information

NPI: 1962762104
Provider Name (Legal Business Name): NORTH COMMUNITY COUNSELING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6037 CLEVELAND AVE
COLUMBUS OH
43231-2256
US

IV. Provider business mailing address

6037 CLEVELAND AVE
COLUMBUS OH
43231-2256
US

V. Phone/Fax

Practice location:
  • Phone: 614-267-7003
  • Fax: 614-267-7013
Mailing address:
  • Phone: 614-267-7003
  • Fax: 614-267-7013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: KATRINA KERNS
Title or Position: CEO
Credential:
Phone: 614-420-4267