Provider Demographics
NPI:1508376245
Name:ACHEAMPONG, ROBERTA (BS)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:ACHEAMPONG
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 E DUBLIN GRANVILLE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3312
Mailing Address - Country:US
Mailing Address - Phone:614-266-9910
Mailing Address - Fax:
Practice Address - Street 1:1425 E DUBLIN GRANVILLE RD STE 105
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3312
Practice Address - Country:US
Practice Address - Phone:614-266-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator