Organization
CONCORD COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA JAKES LISW (EXECUTIVE DIRECTOR)
(614) 882-9338
Entity
Organization
Contact information
Practice address
700 BROOKSEDGE BLVD, WESTERVILLE, OH 43081-2820
(614) 882-9338
(614) 882-3401
Mailing address
700 BROOKSEDGE BLVD, WESTERVILLE, OH 43081-2820
(614) 882-9338
(614) 882-3401
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0213
OH
101YM0800X
Mental Health Counselor
Primary
0213
OH
1041C0700X
Clinical Social Worker
0213
OH
163W00000X
Registered Nurse
—
—
171M00000X
Case Manager/Care Coordinator
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0200375
—
OH
Enumeration date
06/03/2006
Last updated
02/07/2025
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