Provider Demographics
NPI:1225172679
Name:MARKARIAN, CHARLENE RUTH (PCC)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:RUTH
Last Name:MARKARIAN
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:RUTH
Other - Last Name:FULLERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PC
Mailing Address - Street 1:842 RIVA RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-7018
Mailing Address - Country:US
Mailing Address - Phone:614-226-3911
Mailing Address - Fax:
Practice Address - Street 1:1115 BETHEL RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2690
Practice Address - Country:US
Practice Address - Phone:614-538-0353
Practice Address - Fax:614-586-1879
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0007538101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional