WHITE LIGHT BEHAVIORAL HEATH COLUMBUS, LLC
NPI 1295573921
Clinic/Center - Adult Mental Health in Columbus, OH

Active since July 17, 2024CLIA 36D2268112 · Waiver
4040 E BROAD ST, COLUMBUS, OH 43213(614) 705-2767 Get Directions Write a Review

NPPES record last updated: July 17, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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 1295573921) is a healthcare organization registered as an adult mental health in Columbus, Ohio and active in the NPI registry since July 2024. The organization holds a CLIA Waiver certificate valid through June 23, 2027 and lists Laurie Boudreau, Chief Of Staff, as its authorized official.

NPPES Registry Identity

NPI1295573921
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NameWHITE LIGHT BEHAVIORAL HEATH COLUMBUS, LLC
Location Address4040 E BROAD STColumbus, OH 43213-1156
Mailing Address4040 E Broad StColumbus, OH 43213-1156
Organization SubpartNo
Authorized OfficialLaurie BoudreauChief Of Staff · (844) 297-3995
Enumeration DateJuly 17, 2024
NPPES CertifiedJuly 17, 2024
NPI 1295573921 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

4040 E BROAD ST, Columbus, OH 43213

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA 2

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.

Certificate of Waiver 36D2308386

White Light Behavioral Health · Columbus, OH
Expired · Jul 25, 2026
CLIA Number36D2308386
Laboratory TypeDay Treatment Program
Certificate Effective DateJuly 26, 2024
Certificate Expiration DateJuly 25, 2026
Laboratory DirectorRyan Wakim
Laboratory Phone(614) 705-2767
Laboratory LocationWhite Light Behavioral Health4300 East Broad Street, 3rd Floor, Columbus, OH 43213
CLIA data matches this NPI record on: Phone
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.

Registered Nurse (Psychiatric/Mental Health)
4040 E BROAD ST
WHITEHALL, OH 43213
Home Health
4040 E BROAD ST, SUITE 115
COLUMBUS, OH 43213
Counselor (Addiction (Substance Use Disorder))
4040 E BROAD ST
WHITEHALL, OH 43213
Nurse Practitioner (Psychiatric/Mental Health)
4040 E BROAD ST
COLUMBUS, OH 43213
Substance Abuse Rehabilitation Facility
4040 E BROAD ST
COLUMBUS, OH 43213
Licensed Practical Nurse
4040 E BROAD ST
COLUMBUS, OH 43213
Licensed Practical Nurse
4040 E BROAD ST
COLUMBUS, OH 43213
Psychologist (Health Service)
4040 E BROAD ST
COLUMBUS, OH 43213

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 1295573921. It was assigned to this organization in the NPPES registry on July 17, 2024.

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 (614) 705-2767.

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

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

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 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 July 17, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.