Healthcare Provider Details

I. General information

NPI: 1861325417
Provider Name (Legal Business Name): CIRCLE OF LIGHT MENTAL HEALTH AND ADDICTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 MANOR DR
COLUMBUS OH
43232-6438
US

IV. Provider business mailing address

2244 S HAMILTON RD STE 201C
COLUMBUS OH
43232-4390
US

V. Phone/Fax

Practice location:
  • Phone: 614-604-6984
  • Fax:
Mailing address:
  • Phone: 380-224-2056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: QIONA BENNETT
Title or Position: OWNER
Credential:
Phone: 614-397-7307