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General NPI Number Information
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NPI Number | 1992667844
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Entity Type | Organization
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Legal Business Name | KAVANAH PSYCHIATRY LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 179 CREEKSIDE GREEN DR
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City | COLUMBUS
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State | OH
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Zip | 43230-2880
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Country | US
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Telephone | 624-877-6158
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Fax | 614-392-9005
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Provider Business Mailing Address
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Address Line | 179 CREEKSIDE GREEN DR
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City | COLUMBUS
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State | OH
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Zip | 43230-2880
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Country | US
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Telephone | 624-877-6158
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Fax | 614-392-9005
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Authorized Official
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Title or Position | FOUNDER/PMHNP
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Name | OLIVIA DAVIS
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Credential | PMHNP-BC
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Telephone | 614-977-6158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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