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General NPI Number Information
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NPI Number | 1639983984
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Entity Type | Organization
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Legal Business Name | COLLABORATIVE PSYCHIATRY
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 6055 TAIN DR STE 103
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City | DUBLIN
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State | OH
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Zip | 43017-8449
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Country | US
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Telephone | 614-259-8480
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Fax | 614-591-3952
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Provider Business Mailing Address
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Address Line | 6055 TAIN DR STE 103
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City | DUBLIN
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State | OH
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Zip | 43017-8449
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Country | US
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Telephone | 614-259-8480
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Fax | 614-591-3952
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Authorized Official
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Title or Position | CEO AND PSYCHIATRIST
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Name | DR. GRIFFIN STOUT
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Credential | MD
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Telephone | 614-259-8480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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