MEDICARE: MISS ELEANOR RAE KELLEHER LPC

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	101YM0800X	Mental Health Counselor	C.2507147	OH

General Provider Information

NPI Number	:	1831087014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ELEANOR RAE KELLEHER LPC

Provider Business Mailing Address
First Line	:	3994 THE OLD POSTE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-4905
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1670 FISHINGER RD STE 200
Second Line	:
City	:	UPPER ARLINGTON
State	:	OH
Zip	:	43221-1446
Country	:	US
Telephone Number	:	614-456-2540
Fax Number	:

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

Provider Enumeration Date	:	06/25/2025
Last Update Date	:	10/01/2025

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