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WHITE LIGHT BEHAVIORAL HEATH COLUMBUS, LLC
NPI 1194446476
Substance Abuse Rehabilitation Facility in Columbus, OH

Active since September 06, 2022CLIA 36D2268112 · Waiver
4040 E BROAD ST, COLUMBUS, OH 43213(615) 775-1931 Get Directions Write a Review

NPPES record last updated: August 30, 2023. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 30, 2023, Sep 6, 2022 (2 updates tracked since 2022).

About White Light Behavioral Heath Columbus, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WHITE LIGHT BEHAVIORAL HEATH COLUMBUS, LLC (NPI 1194446476) is a healthcare organization registered as a substance abuse rehabilitation facility in Columbus, Ohio and active in the NPI registry since September 2022. The organization holds a CLIA Waiver certificate valid through June 23, 2027, maintains a secondary practice location in Columbus, and lists Laurie Boudreau, Chief Of Staff, as its authorized official.

NPPES Registry Identity

NPI1194446476
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameWHITE LIGHT BEHAVIORAL HEATH COLUMBUS, LLC
Location Address4040 E BROAD STColumbus, OH 43213-1156
Mailing Address4040 E Broad StColumbus, OH 43213-1156 · (614) 350-4010
Phone(615) 775-1931
Organization SubpartNo
Authorized OfficialLaurie BoudreauChief Of Staff · (617) 839-0925
Enumeration DateSeptember 6, 2022
Last NPPES UpdateAugust 30, 20232 updates tracked since enumeration
NPPES CertifiedAugust 30, 2023
✔ NPI 1194446476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Also ListedCommunity Based Residential Treatment Facility, Mental IllnessTaxonomy 320800000X
Also ListedPsychiatric Residential Treatment FacilityTaxonomy 323P00000X
Also ListedSubstance Abuse Rehabilitation Facility · Substance Abuse Treatment, ChildrenTaxonomy 3245S0500X
4040 E BROAD ST, Columbus, OH 43213
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Secondary Practice Location 1

Location 14300 E Broad St Ste 300Columbus, OH 43213-1243 · Phone (614) 350-4010

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, MedMutual, Molina Healthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2268112

White Light Behavioral Health · Columbus, OH
Active · expires Jun 23, 2027
CLIA Number36D2268112
Laboratory TypeDetox Residential Treatme
Certificate Effective DateJune 24, 2025
Certificate Expiration DateJune 23, 2027
Laboratory DirectorRyan Wakim
Laboratory Phone(615) 705-2767
Laboratory LocationWhite Light Behavioral Health4040 E Broad Street, Columbus, OH 43213
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAWNTEL WRIGHT RN
Registered Nurse (Psychiatric/Mental Health)
4040 E BROAD ST
WHITEHALL, OH 43213
Franklin County (844) 297-3995
IDEAL HOME HEALTH INC.
Home Health
4040 E BROAD ST, SUITE 115
COLUMBUS, OH 43213
Franklin County (614) 237-9290
KEIANNA AURELIA MILLER
Peer Specialist
4040 E BROAD ST
COLUMBUS, OH 43213
Franklin County (614) 705-2767
MADISON LAWSON
Counselor (Addiction (Substance Use Disorder))
4040 E BROAD ST
WHITEHALL, OH 43213
Franklin County (614) 405-9500
MARK TUVELLE
Nurse Practitioner (Psychiatric/Mental Health)
4040 E BROAD ST
COLUMBUS, OH 43213
Franklin County (614) 350-1970
LATOYA FINNEY-EL
Licensed Practical Nurse
4040 E BROAD ST
COLUMBUS, OH 43213
Franklin County (614) 705-2767
WHITE LIGHT BEHAVIORAL HEATH COLUMBUS, LLC
Clinic/Center (Adult Mental Health)
4040 E BROAD ST
COLUMBUS, OH 43213
Franklin County (614) 705-2767
JULIANA ASIEDUWAA OTENG SEFAH BSN, RN
Registered Nurse
4040 E BROAD ST
COLUMBUS, OH 43213
Franklin County (614) 705-2767

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is White Light Behavioral Heath Columbus, LLC's NPI number?

The NPI number for White Light Behavioral Heath Columbus, LLC is 1194446476. It was assigned to this organization in the NPPES registry on September 6, 2022.

Where is White Light Behavioral Heath Columbus, LLC located?

White Light Behavioral Heath Columbus, LLC is located at 4040 E Broad St, Columbus, OH 43213. The listed phone number is (615) 775-1931.

What is White Light Behavioral Heath Columbus, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does White Light Behavioral Heath Columbus, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2268112) is associated with this NPI, valid through June 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does White Light Behavioral Heath Columbus, LLC accept?

Health plans from Anthem Blue Cross and Blue Shield, MedMutual and Molina Healthcare list White Light Behavioral Heath Columbus, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for White Light Behavioral Heath Columbus, LLC was last updated on August 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.