Provider Demographics
NPI:1912277385
Name:PLAYFUL THERAPIES LLC
Entity Type:Organization
Organization Name:PLAYFUL THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:BORKAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-937-6326
Mailing Address - Street 1:3140 E BROAD ST
Mailing Address - Street 2:SUITE #101
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2066
Mailing Address - Country:US
Mailing Address - Phone:614-231-9495
Mailing Address - Fax:614-230-2728
Practice Address - Street 1:3140 E BROAD ST
Practice Address - Street 2:SUITE #101
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-2066
Practice Address - Country:US
Practice Address - Phone:614-231-9495
Practice Address - Fax:614-230-2728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4528103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty