NPIMap

Organization Active NPI

Anxiety and Stress Disorders Clinic

  • Clinical Psychologist
  • Columbus, OH
National Provider Identifier
1376713289
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5678 Issued in OH
Legal business name
ANXIETY AND STRESS DISORDERS CLINIC
Practice address
1835 Neil Ave
105 Psychology Building
Columbus, OH 43210-1351
Phone
(614) 292-9484
Fax
(614) 292-4539
NPI assigned
Mar 6, 2008
Last updated
Jun 17, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
THE OHIO STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Dr. Joseph Philip Decola, PH.D.
Title
Director of Clinical Services
Phone
(614) 292-9484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5678 OH Primary

Addresses

Primary practice location

1835 Neil Ave
105 Psychology Building
Columbus, OH 43210-1351

Mailing address

1835 Neil Ave
105 Psychology Building
Columbus, OH 43210-1351
Phone (614) 292-9484

National Provider Directory

National Provider Directory
Tax ID family
Ohio State University H11 organizations share this tax ID, including this one
Part of
Ohio State University H

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1835 Neil Ave
#105
Columbus, OH 43210
Phone (614) 292-9484

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1376713289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 NEIL AVE",
            "address_2": "105 PSYCHOLOGY BUILDING",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101351",
            "telephone_number": "614-292-9484",
            "fax_number": "614-292-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 NEIL AVE",
            "address_2": "105 PSYCHOLOGY BUILDING",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101351",
            "telephone_number": "614-292-9484",
            "fax_number": "614-292-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANXIETY AND STRESS DISORDERS CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE OHIO STATE UNIVERSITY",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "DECOLA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "614-292-9484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5678",
            "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 17, 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.