| I Am Boundless, Inc | |
|
445 E Dublin Granville Rd Worthington OH 43085-3192 | |
| (614) 844-3800 | |
| (614) 515-5779 |
| Full Name | I Am Boundless, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 445 E Dublin Granville Rd, Worthington, Ohio |
| Authorized Official Name and Position | Michelle Barner (REIMBURSEMENT MANAGER) |
| Authorized Official Contact | 6148443800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| I Am Boundless, Inc 445 E Dublin Granville Rd Worthington OH 43085-3192 Ph: (614) 844-3800 | I Am Boundless, Inc 445 E Dublin Granville Rd Worthington OH 43085-3192 Ph: (614) 844-3800 |
| NPI Number | 1891458477 |
|---|---|
| Provider Enumeration Date | 10/20/2021 |
| Last Update Date | 06/03/2022 |
| Certification Date | 06/03/2022 |
| Medicare PECOS PAC ID | 9931596103 |
|---|---|
| Medicare Enrollment ID | O20220419000971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891458477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Christopher D Daugherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750784484 PECOS PAC ID: 8628381621 Enrollment ID: I20150720003423 |
| Provider Name | James J Lindsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790038016 PECOS PAC ID: 4789969916 Enrollment ID: I20170330000358 |
| Provider Name | Michelle Marko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346762465 PECOS PAC ID: 3577833284 Enrollment ID: I20170727002676 |
| Provider Name | Kirsten L Crummel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912436023 PECOS PAC ID: 6507112380 Enrollment ID: I20180710000384 |
| Provider Name | Jennifer M Saelens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174088926 PECOS PAC ID: 7113267790 Enrollment ID: I20190318001982 |
| Provider Name | Tonya Lynn Camden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932629441 PECOS PAC ID: 6507130622 Enrollment ID: I20200519002583 |
| Provider Name | Cynthia Ripsin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457328296 PECOS PAC ID: 8426048299 Enrollment ID: I20210820000856 |
| Provider Name | Kristen Ashley Rasmussen Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982228102 PECOS PAC ID: 3971994849 Enrollment ID: I20220104000353 |
| Provider Name | Jamie Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912555434 PECOS PAC ID: 3971990359 Enrollment ID: I20220504001032 |
| Provider Name | Arianne Koon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922532365 PECOS PAC ID: 1850777558 Enrollment ID: I20221004001449 |
| Provider Name | Andrew Burkett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750897567 PECOS PAC ID: 6305281858 Enrollment ID: I20240223003734 |
| Provider Name | Julie A Battaglia |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629596275 PECOS PAC ID: 3072958719 Enrollment ID: I20240304002269 |
| Provider Name | Shelby Rudloff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013429919 PECOS PAC ID: 9739526245 Enrollment ID: I20240320000569 |
| Provider Name | William Kiley Ritt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407334824 PECOS PAC ID: 1254770548 Enrollment ID: I20240419000621 |
| Provider Name | Jill Marie Brenneman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619645157 PECOS PAC ID: 0446780167 Enrollment ID: I20250211002476 |
| Provider Name | Monica Gonzalez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528264876 PECOS PAC ID: 3870016116 Enrollment ID: I20250327002632 |
| Provider Name | Kwentor Q Uwechue |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760712202 PECOS PAC ID: 4880105295 Enrollment ID: I20250613000374 |
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