Provider Demographics
NPI:1467810341
Name:CAMPAGNA, JENNY (LPCC-S)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:CAMPAGNA
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 1:1665 WELDON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-4359
Mailing Address - Country:US
Mailing Address - Phone:614-404-7721
Mailing Address - Fax:
Practice Address - Street 1:5701 N HIGH ST STE 201
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3960
Practice Address - Country:US
Practice Address - Phone:614-404-7721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1200226-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2615030Medicaid