Provider Demographics
NPI:1023463080
Name:JONI KRZYCKI PHD LLC
Entity type:Organization
Organization Name:JONI KRZYCKI PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONI
Authorized Official - Middle Name:L
Authorized Official - Last Name:KRZYCKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-619-2259
Mailing Address - Street 1:500 W WILSON BRIDGE RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2238
Mailing Address - Country:US
Mailing Address - Phone:614-619-2259
Mailing Address - Fax:614-847-9322
Practice Address - Street 1:500 W WILSON BRIDGE RD
Practice Address - Street 2:SUITE 240
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2238
Practice Address - Country:US
Practice Address - Phone:614-619-2259
Practice Address - Fax:614-847-9322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-7530104100000X
OH6321103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty