Provider Demographics
NPI:1265503536
Name:AFFIRMATIONS PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:AFFIRMATIONS PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:AFFIRMATIONS- A CENTER FOR PSYCHOTHERAPY AND GROWTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FUCHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-358-1643
Mailing Address - Street 1:620 E BROAD ST.
Mailing Address - Street 2:STE. 100 & 301
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4037
Mailing Address - Country:US
Mailing Address - Phone:614-445-8277
Mailing Address - Fax:614-445-8283
Practice Address - Street 1:620 E BROAD ST.
Practice Address - Street 2:STE. 100 & 301
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4037
Practice Address - Country:US
Practice Address - Phone:614-445-8277
Practice Address - Fax:614-445-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0855X, 261QM1300X
OH305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0087460Medicaid
OHH180520Medicare PIN