Organization
OSU PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LUCAS (EXECUTIVE DIRECTOR OSU & HARDING)
(614) 293-8283
Entity
Organization
Contact information
Practice address
1670 UPHAM DR, SUITE 140, COLUMBUS, OH 43210-1250
(614) 293-9600
(614) 293-4200
Mailing address
1670 UPHAM DR, SUITE 140, COLUMBUS, OH 43210-1250
(614) 293-9600
(614) 293-4200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2454035
—
OH
Enumeration date
05/04/2006
Last updated
05/31/2012
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