Jon Bourn, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

P.7675 Issued in OH

Practice address

30 W Woodruff Ave
Columbus, OH 43210-1118

Phone

(614) 931-0228

NPI assigned

Aug 8, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Reset Button Counseling LLC

  • Clinical Psychologist
  • Columbus, OH
  • NPI 1275184723
  NPD

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1811306384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 HANFORD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432062820",
            "telephone_number": "614-931-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W WOODRUFF AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101118",
            "telephone_number": "614-931-0228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7714 Conner Rd",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Powell",
            "state": "TN",
            "postal_code": "378493559",
            "country_code": "US",
            "telephone_number": "865-947-6220",
            "fax_number": "865-512-1069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURN",
        "first_name": "JON",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-08",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "P.7675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian P Bourgeois, DDS
• Frederick Wayne Bourgeois, DDS
• Trevor A Bourgeois, DDS
• Rachael Erin Bourget
• Jamie Bourn
• Michael V Bourn, DO
• Brittany Nicole Bourne, APRN-CNP
• Christina Bournique
• Sharon Bout-Tabaku, M.D.
• Petra Nihad Boutros, DMD

• Counseling Psychologist in Columbus, OH
• Providers in Columbus, OH by specialty
• Counseling Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.