Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Licking Memorial Professional Corp

Organization Psychiatry Physician · NPI 1295809614

Licking Memorial Professional Corp is a Psychiatry Physician in Pataskala, Ohio. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1 Healthy Pl Ste 105
Pataskala, OH 43062-7067
Phone: (740) 348-1930
Fax: (740) 348-1931
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X

Record details

NPI number1295809614
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Montagnese — Executive Vice President · (740) 348-4000
Other names Licking Memorial Behavioral Health Pataskala
NPI enumeratedNovember 17, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1 Healthy Pl, Suite 105, Pataskala, OH 43062-7067