MEDICARE: AARON JARRELL MSE, LPC, CDCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDCA.165874	OH
2	101YP2500X	Professional Counselor	E.2303876	OH

General Provider Information

NPI Number	:	1316433790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON JARRELL MSE, LPC, CDCA

Provider Business Mailing Address
First Line	:	1900 BRICE RD
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-3403
Country	:	US
Telephone Number	:	614-239-9965
Fax Number	:	614-239-9971

Provider Business Practice Location Address
First Line	:	620 E BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-4037
Country	:	US
Telephone Number	:	614-674-6076
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2018
Last Update Date	:	01/26/2024

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