Individual provider · Type 1 NPI

Veomany Phouthavong, CDCA

Peer Specialist · Columbus, OH

NPI number 1194474502 Active

Practice location

4177 E Broad St
Columbus, OH 43213-1217

Call (614) 697-1313 Map

Mailing address

4214 E Main St
Whitehall, OH 43213-3028

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X180611 (OH)
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1194474502

Veomany Phouthavong, CDCA's National Provider Identifier is 1194474502, issued on Mar 22, 2022. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Columbus, OH. The record was last updated on Feb 7, 2023.