Healthcare Provider Details

I. General information

NPI: 1508604703
Provider Name (Legal Business Name): SOUNDCITIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2024
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 CLEVELAND AVE STE E
COLUMBUS OH
43231-4756
US

IV. Provider business mailing address

5200 CLEVELAND AVE STE E
COLUMBUS OH
43231-4756
US

V. Phone/Fax

Practice location:
  • Phone: 206-739-1790
  • Fax:
Mailing address:
  • Phone: 614-407-4614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/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 Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SAHRA SHIRDON
Title or Position: CEO
Credential:
Phone: 614-407-4614