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General NPI Number Information
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NPI Number | 1619601655
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Entity Type | Organization
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Legal Business Name | ELIZABETH KAKUNGULU CLINICAL COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 4100 HORIZONS DR STE 213
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City | COLUMBUS
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State | OH
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Zip | 43220-0019
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Country | US
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Telephone | 614-858-5100
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Fax | 614-858-5180
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Provider Business Mailing Address
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Address Line | 4100 HORIZONS DR STE 213
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City | COLUMBUS
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State | OH
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Zip | 43220-0019
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Country | US
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Telephone | 614-858-5100
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Fax | 161-485-8518
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH KAKUNGULU
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Credential | LISW-S
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Telephone | 614-858-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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