Healthcare Provider Details

I. General information

NPI: 1942111513
Provider Name (Legal Business Name): NORTHSTAR ABA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2674 SUNBURY CT
COLUMBUS OH
43219
US

IV. Provider business mailing address

2606 HILLIARD ROME RD PMB 2006
HILLIARD OH
43026-9468
US

V. Phone/Fax

Practice location:
  • Phone: 614-805-4844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: ADAN BARRE
Title or Position: CEO
Credential:
Phone: 614-805-4844