Healthcare Provider Details

I. General information

NPI: 1942164751
Provider Name (Legal Business Name): CROWN BH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4133 E MAIN ST
COLUMBUS OH
43213-2951
US

IV. Provider business mailing address

4133 E MAIN ST
COLUMBUS OH
43213-2951
US

V. Phone/Fax

Practice location:
  • Phone: 614-350-0013
  • Fax:
Mailing address:
  • Phone: 614-350-0013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CASEY BRIGHT
Title or Position: CEO
Credential: CEO
Phone: 614-350-0013