Healthcare Provider Details

I. General information

NPI: 1225948862
Provider Name (Legal Business Name): CHRISTOPHER JURGENS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7171 SAWMILL PKWY STE 2A
POWELL OH
43065-7828
US

IV. Provider business mailing address

2076 WENDYS DR APT 28
COLUMBUS OH
43220-2420
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-9600
  • Fax:
Mailing address:
  • Phone: 614-273-4272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberP.09035
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP.09035
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: