Provider Demographics
NPI:1962762104
Name:NORTH COMMUNITY COUNSELING CENTERS, INC.
Entity type:Organization
Organization Name:NORTH COMMUNITY COUNSELING CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KERNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-420-4267
Mailing Address - Street 1:6037 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-2256
Mailing Address - Country:US
Mailing Address - Phone:614-267-7003
Mailing Address - Fax:614-267-7013
Practice Address - Street 1:6037 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-2256
Practice Address - Country:US
Practice Address - Phone:614-267-7003
Practice Address - Fax:614-267-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0065455Medicaid
OH0065455Medicaid