Provider Demographics
NPI:1396870234
Name:DAVID J TENNENBAUM PHD ASSOCIATES
Entity type:Organization
Organization Name:DAVID J TENNENBAUM PHD ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:TENNENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-451-6517
Mailing Address - Street 1:5151 REED RD
Mailing Address - Street 2:SUITE A211
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2553
Mailing Address - Country:US
Mailing Address - Phone:614-451-6517
Mailing Address - Fax:614-451-5387
Practice Address - Street 1:5151 REED RD
Practice Address - Street 2:SUITE A211
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2553
Practice Address - Country:US
Practice Address - Phone:614-451-6517
Practice Address - Fax:614-451-5387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH103TF0000X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty