| Grace Blossoms Behavioral Health | |
|
7628 Slate Ridge Blvd Reynoldsburg OH 43068-8159 | |
| (614) 354-0464 | |
| Not Available |
| Full Name | Grace Blossoms Behavioral Health |
|---|---|
| Speciality | Social Worker |
| Location | 7628 Slate Ridge Blvd, Reynoldsburg, Ohio |
| Authorized Official Name and Position | Christina Rovah (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6143540464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Blossoms Behavioral Health 7628 Slate Ridge Blvd Reynoldsburg OH 43068-8159 Ph: (614) 354-0464 | Grace Blossoms Behavioral Health 7628 Slate Ridge Blvd Reynoldsburg OH 43068-8159 Ph: (614) 354-0464 |
| NPI Number | 1659833655 |
|---|---|
| Provider Enumeration Date | 04/01/2019 |
| Last Update Date | 04/08/2022 |
| Certification Date | 04/08/2022 |
| Medicare PECOS PAC ID | 1658602206 |
|---|---|
| Medicare Enrollment ID | O20191011001447 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659833655 | NPI | - | NPPES |
| 0345877 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christina Thorpe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689112401 PECOS PAC ID: 4082998521 Enrollment ID: I20170301002498 |
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