Provider Demographics
NPI:1487972329
Name:NEUROFEEDBACK AND COUNSELING OF COLUMBUS LLC
Entity type:Organization
Organization Name:NEUROFEEDBACK AND COUNSELING OF COLUMBUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:PC
Authorized Official - Phone:614-203-0104
Mailing Address - Street 1:3669 MEDBROOK WAY N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3601
Mailing Address - Country:US
Mailing Address - Phone:614-203-0104
Mailing Address - Fax:
Practice Address - Street 1:4041 N HIGH ST STE 402K
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3253
Practice Address - Country:US
Practice Address - Phone:614-203-0104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-15
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0800130-CR101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty