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General NPI Number Information
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NPI Number | 1023983012
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Entity Type | Organization
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Legal Business Name | ANANEO THERAPY GROUP LLC
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 4449 EASTON WAY STE 2064
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City | COLUMBUS
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State | OH
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Zip | 43219-6093
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Country | US
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Telephone | 614-321-7901
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Fax |
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Provider Business Mailing Address
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Address Line | 4449 EASTON WAY STE 2064
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City | COLUMBUS
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State | OH
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Zip | 43219-6093
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Country | US
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Telephone | 614-321-7901
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | MRS. TIVONA LEA BANKS
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Credential | LPCC
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Telephone | 614-290-6633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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