Provider Demographics
NPI:1467074740
Name:ODONNELL, NORA (LPCC-S)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:ODONNELL
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 RADER ALY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-1169
Mailing Address - Country:US
Mailing Address - Phone:440-829-1670
Mailing Address - Fax:
Practice Address - Street 1:2029 RIVERSIDE DR STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-4079
Practice Address - Country:US
Practice Address - Phone:614-398-3771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-10
Last Update Date:2020-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1200344-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty