Healthcare Provider Details

I. General information

NPI: 1770420457
Provider Name (Legal Business Name): INTRINSIC PROMISE COMMUNITY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3442 RIVERSIDE DR
UPPER ARLINGTON OH
43221-1743
US

IV. Provider business mailing address

3442 RIVERSIDE DR
UPPER ARLINGTON OH
43221-1743
US

V. Phone/Fax

Practice location:
  • Phone: 614-352-2379
  • Fax: 614-352-2379
Mailing address:
  • Phone: 614-352-2379
  • Fax: 614-352-2379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DEMETRA T TAYLOR
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: PHD, LPCC
Phone: 614-859-0213