Healthcare Provider Details

I. General information

NPI: 1417413287
Provider Name (Legal Business Name): ANDREW SOKOL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2019
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 TAYLOR RD STE 100
GAHANNA OH
43230-3520
US

IV. Provider business mailing address

132 EDMONDS DR
COMMERCIAL POINT OH
43116-9739
US

V. Phone/Fax

Practice location:
  • Phone: 614-451-4465
  • Fax:
Mailing address:
  • Phone: 614-451-4465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberCOBA.00914
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: