Provider Demographics
NPI:1154617926
Name:AMES, ABBIE
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:
Last Name:AMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5354 N HIGH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1274
Mailing Address - Country:US
Mailing Address - Phone:614-948-7300
Mailing Address - Fax:614-948-7340
Practice Address - Street 1:5354 N HIGH ST STE 206
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214
Practice Address - Country:US
Practice Address - Phone:614-948-7300
Practice Address - Fax:614-948-7340
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OHE.1800758101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08258Medicaid