Ohio Center for Adolescent Wellness LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

OHIO CENTER FOR ADOLESCENT WELLNESS LLC

Practice address

150 E Wilson Bridge Rd Ste 100
Worthington, OH 43085-2328

Phone

(888) 920-6370

NPI assigned

Nov 20, 2024

Last updated

Nov 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edward Thatcher

Title

Chief Financial Officer

Phone

(754) 217-8127

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1417772971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E WILSON BRIDGE RD STE 100",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E WILSON BRIDGE RD STE 100",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852328",
            "telephone_number": "888-920-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO CENTER FOR ADOLESCENT WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "THATCHER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "754-217-8127"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Worthington, OH
• Providers in Worthington, OH by specialty
• Adolescent and Children Mental Health Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.