Healthcare Provider Details

I. General information

NPI: 1144763574
Provider Name (Legal Business Name): COLUMBUS BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2016
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 COMMERCE PARK DR
WESTERVILLE OH
43082-6054
US

IV. Provider business mailing address

115 COMMERCE PARK DR
WESTERVILLE OH
43082-6054
US

V. Phone/Fax

Practice location:
  • Phone: 614-360-2600
  • Fax: 844-320-2600
Mailing address:
  • Phone: 614-360-2600
  • Fax: 844-320-2600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number7125
License Number StateOH

VIII. Authorized Official

Name: DR. KAREN BRETZ
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 614-360-2600