=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285547307
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NATIONWIDE CHILDREN'S HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2026
-----------------------------------------------------
Last Update Date | 09/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 444 BUTTERFLY GARDENS DR STE 2A
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43215-3427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-355-8695
-----------------------------------------------------
Fax | 614-355-8620
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5265 FRISCO DR
-----------------------------------------------------
City | HILLIARD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43026-8925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-867-8164
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OUTPATIENT ACUTE THERAPIST
-----------------------------------------------------
Name | GRACE LARA DAKWAR
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 614-938-0180
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------