Ohio Gambling Telehealth Network

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

OHIO GAMBLING TELEHEALTH NETWORK

Practice address

355 E Campus View Blvd Ste 285
Columbus, OH 43235-5680

Phone

(614) 750-9899

NPI assigned

Sep 13, 2023

Last updated

Oct 23, 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

Derek Longmeier

Title

Executive Director

Phone

(614) 750-9899

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olivia Cheyenne Burris, LCDCII

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
  • NPI 1821879875
  NPD
• Katrina Arroyo

  • Professional Counselor
  • Cleveland, OH
  • NPI 1205363694
  NPD (past)
• Kenneth Phillip Buzzelli, LISW LICDC

  • Clinical Social Worker
  • Cuyahoga Falls, OH
  • NPI 1972510568
  NPD (past)
• Jesse Wodrig, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Ashtabula, OH
  • NPI 1144727678
  NPD (past)

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1720865579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E CAMPUS VIEW BLVD STE 285",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432355680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E CAMPUS VIEW BLVD STE 285",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432355680",
            "telephone_number": "614-750-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO GAMBLING TELEHEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "LONGMEIER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "614-750-9899"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ohio Heallth
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• Community/Behavioral Health Agency in Columbus, OH
• Providers in Columbus, OH by specialty
• Community/Behavioral Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.