Provider Demographics
NPI:1831217926
Name:DORN COUNSELING AND CONSULTING, INC
Entity type:Organization
Organization Name:DORN COUNSELING AND CONSULTING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL CLINICAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LIN
Authorized Official - Last Name:DORN
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:614-227-0181
Mailing Address - Street 1:691 N HIGH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1583
Mailing Address - Country:US
Mailing Address - Phone:614-227-0181
Mailing Address - Fax:614-227-0516
Practice Address - Street 1:691 N HIGH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1583
Practice Address - Country:US
Practice Address - Phone:614-227-0181
Practice Address - Fax:614-227-0516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6260257Medicare UPIN
OH197645463002Medicare UPIN
OH=========Medicare UPIN
OH000000276215Medicare UPIN