Healthcare Provider Details

I. General information

NPI: 1205329356
Provider Name (Legal Business Name): JACIE ANNE OKOJIE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 MANNING PKWY STE B
POWELL OH
43065-7298
US

IV. Provider business mailing address

1480 MANNING PKWY STE B
POWELL OH
43065-7298
US

V. Phone/Fax

Practice location:
  • Phone: 614-888-9200
  • Fax:
Mailing address:
  • Phone: 614-888-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2406613
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: