Provider Demographics
NPI:1104900422
Name:AHL, PAT (LPC, NCC)
Entity type:Individual
Prefix:
First Name:PAT
Middle Name:
Last Name:AHL
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4746 HAYDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-5516
Mailing Address - Country:US
Mailing Address - Phone:614-529-8200
Mailing Address - Fax:614-529-8517
Practice Address - Street 1:136 NORTHWOODS BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4728
Practice Address - Country:US
Practice Address - Phone:614-529-8200
Practice Address - Fax:614-529-8517
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC08385101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional