Healthcare Provider Details
I. General information
NPI: 1265503536
Provider Name (Legal Business Name): AFFIRMATIONS PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/10/2006
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
620 E BROAD ST. STE. 100 & 301
COLUMBUS OH
43215-4037
US
IV. Provider business mailing address
620 E BROAD ST. STE. 100 & 301
COLUMBUS OH
43215-4037
US
V. Phone/Fax
- Phone: 614-445-8277
- Fax: 614-445-8283
- Phone: 614-445-8277
- Fax: 614-445-8283
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 305R00000X |
| Taxonomy | Preferred Provider Organization |
| License Number | |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LESLIE
FUCHS
Title or Position: PRESIDENT
Credential:
Phone: 810-358-1643