ACCESS BEHAVIORAL LLC

Provider Demographics

• NPI: 1437463213
• Name: ACCESS BEHAVIORAL LLC
• Entity Type: Organization
• Organization Name: ACCESS BEHAVIORAL LLC
• Other - Org Name: ACCESS HEALTH NETWORK
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: CEO/OWNER
• Authorized Official - Prefix: DR
• Authorized Official - First Name: JOHN
• Authorized Official - Middle Name: A
• Authorized Official - Last Name: JOHNSON
• Authorized Official - Credentials: MD
• Authorized Official - Phone: 614-655-3345
• Mailing Address - Street 1: 6400 E BROAD ST STE 400
• Mailing Address - City: COLUMBUS
• Mailing Address - State: OH
• Mailing Address - Zip Code: 43213-2979
• Mailing Address - Country: US
• Mailing Address - Phone: 614-655-3345
• Mailing Address - Fax: 614-317-4689
• Practice Address - Street 1: 99 N BRICE RD
• Practice Address - Street 2: STE 220
• Practice Address - City: COLUMBUS
• Practice Address - State: OH
• Practice Address - Zip Code: 43213-6510
• Practice Address - Country: US
• Practice Address - Phone: 614-322-9760
• Practice Address - Fax: 614-322-9762
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2010-08-04
• Last Update Date: 2020-06-23

Provider Licenses

State	License ID	Taxonomies
		261QM1300X, 261QM2500X, 2084P0800X
OH	1.0800223-SUPV	104100000X
OH	1.0700146-SUPV	104100000X
OH	1.0600163-SUPV	104100000X
OH	35.069048	2084P0800X
OH	35.064318	2084P0800X
OH	35.067651	2084P0800X
OH	35.028306	2084P0800X
OH	35.093365	2084P0800X
OH	35.093514	2084P0800X
OH	35.074564	2084P0800X
OH	35.048675	2084P0800X
OH	35.093354	2084P0804X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	2084P0800X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Psychiatry	Group - Multi-Specialty
No	261QM1300X	Ambulatory Health Care Facilities	Clinic/Center	Multi-Specialty	Group - Multi-Specialty
Yes	261QM2500X	Ambulatory Health Care Facilities	Clinic/Center	Medical Specialty	Group - Multi-Specialty
No	104100000X	Behavioral Health & Social Service Providers	Social Worker		Group - Multi-Specialty
No	2084P0804X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Child & Adolescent Psychiatry	Group - Multi-Specialty