Provider Demographics
NPI:1619689163
Name:LACUNA COUNSELING LLC
Entity Type:Organization
Organization Name:LACUNA COUNSELING LLC
Other - Org Name:LACUNA COUNSELING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HELLDOERFER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, ATR
Authorized Official - Phone:614-545-8784
Mailing Address - Street 1:1120 URANA AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3335
Mailing Address - Country:US
Mailing Address - Phone:614-545-8784
Mailing Address - Fax:
Practice Address - Street 1:731 E BROAD ST.
Practice Address - Street 2:FLOOR 2 SUITE 8
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205
Practice Address - Country:US
Practice Address - Phone:614-285-5013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0286682Medicaid