Healthcare Provider Details

I. General information

NPI: 1013608280
Provider Name (Legal Business Name): THE CENTER FOR RESILIENCE & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 E MAIN ST STE B
COLUMBUS OH
43209-2579
US

IV. Provider business mailing address

2740 E MAIN ST STE B
COLUMBUS OH
43209-2579
US

V. Phone/Fax

Practice location:
  • Phone: 614-285-6574
  • Fax:
Mailing address:
  • Phone: 614-285-6574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JENNIFER WEBB MYSER
Title or Position: FOUNDER, DIRECTOR
Credential: PSY.D.
Phone: 614-285-6574