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General NPI Number Information
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NPI Number | 1760375778
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Entity Type | Organization
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Legal Business Name | A & E BEHAVIORAL HEALTHCARE PLLC
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 170 NORTHWOODS BLVD STE 210
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City | COLUMBUS
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State | OH
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Zip | 43235-4711
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Country | US
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Telephone | 509-204-7249
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Fax |
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Provider Business Mailing Address
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Address Line | 170 NORTHWOODS BLVD STE 210
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City | COLUMBUS
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State | OH
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Zip | 43235-4711
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Country | US
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Telephone | 509-204-7249
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Fax |
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Authorized Official
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Title or Position | LICENSED INDEPENDENT SOCIAL WORKER
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Name | RUDESTA EDWARDS-UGIOMOH
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Credential | LISW, MSW
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Telephone | 509-204-7249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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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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