Healthcare Provider Details

I. General information

NPI: 1093347064
Provider Name (Legal Business Name): NEW SEASON COUNSELING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5460 CLEVELAND AVE
COLUMBUS OH
43231-4074
US

IV. Provider business mailing address

3197 E DUBLIN GRANVILLE RD
COLUMBUS OH
43231-4035
US

V. Phone/Fax

Practice location:
  • Phone: 614-568-8236
  • Fax: 614-725-2829
Mailing address:
  • Phone: 614-880-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DAVID RONALD WEAVER II
Title or Position: SENIOR MANAGER
Credential:
Phone: 614-330-0108