Healthcare Provider Details

I. General information

NPI: 1255734570
Provider Name (Legal Business Name): PAMELA MILLER-CROOKS M.A., LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 N FORGE ST
AKRON OH
44304-1317
US

IV. Provider business mailing address

18 N FORGE ST
AKRON OH
44304-1317
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-0591
  • Fax:
Mailing address:
  • Phone: 330-762-0591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.1700217-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: