Provider Demographics
NPI:1043920838
Name:RESILIENT CHILDREN AND FAMILIES
Entity Type:Organization
Organization Name:RESILIENT CHILDREN AND FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:MASON
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-361-5552
Mailing Address - Street 1:2175 S JAMES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-3850
Mailing Address - Country:US
Mailing Address - Phone:614-361-5552
Mailing Address - Fax:614-826-0182
Practice Address - Street 1:2175 S JAMES RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-3850
Practice Address - Country:US
Practice Address - Phone:614-361-5552
Practice Address - Fax:614-826-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1508379686OtherNPI