Provider Demographics
NPI:1881475200
Name:GENTLEPSYCH
Entity type:Organization
Organization Name:GENTLEPSYCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NIESE
Authorized Official - Suffix:
Authorized Official - Credentials:CNP, PMHNP
Authorized Official - Phone:740-391-0870
Mailing Address - Street 1:132 NORTHWOODS BLVD STE C2
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4726
Mailing Address - Country:US
Mailing Address - Phone:614-660-5992
Mailing Address - Fax:614-639-8258
Practice Address - Street 1:132 NORTHWOODS BLVD STE C2
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4726
Practice Address - Country:US
Practice Address - Phone:614-660-5992
Practice Address - Fax:614-639-8258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty