Provider Demographics
NPI:1598039513
Name:GENTILE, J. ERIC (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:J. ERIC
Middle Name:
Last Name:GENTILE
Suffix:
Gender:M
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20745
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0745
Mailing Address - Country:US
Mailing Address - Phone:614-940-9834
Mailing Address - Fax:
Practice Address - Street 1:1625 BETHEL RD STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2071
Practice Address - Country:US
Practice Address - Phone:614-940-9834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-08
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1100307101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional