Individual provider Active NPI

Celestine Ateafacktaleh

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1184235608
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0040292 Issued in OH
Practice address
1495 Morse Rd Ste 209C
Columbus, OH 43229-6434
Phone
(614) 260-8806
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 0040292 OH Primary
Registered Nurse 163W00000X 462396 OH

Addresses

Primary practice location

1495 Morse Rd Ste 209C
Columbus, OH 43229-6434

Mailing address

5900 Roche Dr Ste 260B
Columbus, OH 43229-3272
Phone (614) 260-8806

Other practice location 1

5900 Roche Dr Ste 260B
Columbus, OH 43229-3272
Phone (614) 260-8806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251230002951 OH Practitioner - Nurse Practitioner 0446746333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1495 Morse Rd
Columbus, OH 43229-6434
Phone (614) 260-8806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
462396OHMDRegistered Nurse
0040292OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Patient Centered Mental Health Services LLC Single Specialty CurrentSince Oct 1, 2025 Accepting new patients

Locations

1495 Morse Rd
Ste 209C
Columbus, OH 43229
Phone (614) 260-8806

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1184235608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 ROCHE DR STE 260B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293272",
            "telephone_number": "614-260-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 MORSE RD STE 209C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432296434",
            "telephone_number": "614-260-8806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Roche Dr Ste 260B",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432293272",
            "country_code": "US",
            "telephone_number": "614-260-8806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATEAFACKTALEH",
        "first_name": "CELESTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0040292",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "462396",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.