Moffou Katherine Tchoula

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2102824-SUPV Issued in OH

Practice address

4488 W Broad St
Columbus, OH 43228-5610

Phone

(614) 334-6903

NPI assigned

Oct 29, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Lighthouse Behavioral Health Solutions, LLCGroup PAC ID 4486089893, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lighthouse Behavioral Health Solutions, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Columbus, OH
  • NPI 1629560230

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• Ernestine Counseling, LLC

  • Clinical Social Worker
  • Columbus, OH
  • NPI 1730892563
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710633600000",
    "number": "1003450511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432132950",
            "telephone_number": "614-334-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4488 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432285610",
            "telephone_number": "614-334-6903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3763 N High St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143547",
            "country_code": "US",
            "telephone_number": "614-406-0299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TCHOULA",
        "first_name": "MOFFOU",
        "middle_name": "KATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2024-03-17",
        "certification_date": "2024-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2102824-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Taylor
• Yardley Wulf Taylor, APRN-CNP
• Tayo Home Healthcare LLC
• TBK Wound Management LLC
• Heather Tchobanian, LSW
• Odette T Tchounguen
• Claude Tchouotchip
• Tci Marketing Group LLC
• Delois Teague, M.D.
• Erica Janelle Teague

• Clinical Social Worker in Columbus, OH
• Providers in Columbus, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.