Healthcare Provider Details

I. General information

NPI: 1467541441
Provider Name (Legal Business Name): CHOICES FOR VICTIMS OF DOMESTIC VIOLENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 N CASSADY AVE
COLUMBUS OH
43219-1512
US

IV. Provider business mailing address

1105 SCHROCK RD STE 100
COLUMBUS OH
43229-1165
US

V. Phone/Fax

Practice location:
  • Phone: 614-224-6617
  • Fax: 614-337-1186
Mailing address:
  • Phone: 614-224-6617
  • Fax: 614-337-1186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number078
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: DR. MARIA HOUSTON
Title or Position: EXECUTIVE DIRECTOR
Credential: PSYD
Phone: 614-453-4383