Organization Active NPI

Jack Stoneburner & Associates LLC

  • Mental Health Counselor
  • Columbus, OH
National Provider Identifier
1114174976
Registry record updated Nov 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
I3017 Issued in OH
Legal business name
JACK STONEBURNER & ASSOCIATES LLC
Practice address
1910 Crown Park CT
Columbus, OH 43235-2404
Phone
(614) 457-8359
Fax
(614) 457-6898
NPI assigned
Aug 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2008

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

Authorized official

Name
Mr. Jack Leroy Stoneburner, MSW, LISW
Title
President
Phone
(614) 457-8359

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X I3017 OH Primary

Addresses

Primary practice location

1910 Crown Park CT
Columbus, OH 43235-2404

Mailing address

1910 Crown Park CT
Columbus, OH 43235-2404
Phone (614) 457-8359

National Provider Directory

National Provider Directory

Locations

1910 Crown Park Ct
Columbus, OH 43235
Phone (614) 457-8359

5655 N High St
Ste 208
Worthington, OH 43085
Phone (614) 505-6977

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227657600000",
    "number": "1114174976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 CROWN PARK CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432352404",
            "telephone_number": "614-457-8359",
            "fax_number": "614-457-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 CROWN PARK CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432352404",
            "telephone_number": "614-457-8359",
            "fax_number": "614-457-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK STONEBURNER & ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-25",
        "last_updated": "2008-11-26",
        "status": "A",
        "authorized_official_last_name": "STONEBURNER",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-457-8359",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, LISW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I3017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.