Individual provider Active NPI

Kelly Verdibello

  • Marriage & Family Therapist
  • Columbus, OH
National Provider Identifier
1194271395
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
F.2100196 Issued in OH
Practice address
431 E Broad St
Columbus, OH 43215
Phone
(614) 885-5020
Fax
(614) 750-1251
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X F.2100196 OH Primary

Addresses

Primary practice location

431 E Broad St
Columbus, OH 43215

Mailing address

4894 Silver Bow Dr
Hilliard, OH 43026-8525

Other practice location 1

309 White Plains Rd
Eastchester, NY 10709-2801
Phone (419) 704-2201

Other practice location 2

6717 Bluebird Pl
Hilliard, OH 43026-2263
Phone (419) 704-2201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
F.2100196OHMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1194271395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4894 SILVER BOW DR",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430268525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43215",
            "telephone_number": "614-885-5020",
            "fax_number": "614-750-1251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 White Plains Rd",
            "address_purpose": "LOCATION",
            "city": "Eastchester",
            "state": "NY",
            "postal_code": "107092801",
            "country_code": "US",
            "telephone_number": "419-704-2201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6717 Bluebird Pl",
            "address_purpose": "LOCATION",
            "city": "Hilliard",
            "state": "OH",
            "postal_code": "430262263",
            "country_code": "US",
            "telephone_number": "419-704-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERDIBELLO",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "F.2100196",
            "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 Jun 29, 2021; 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.