Healthcare Provider Details

I. General information

NPI: 1659440360
Provider Name (Legal Business Name): BARBARA ANN WERSTLER SACCOGNA PCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
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: 330-794-4262
Mailing address:
  • Phone: 330-762-0591
  • Fax: 330-794-4262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE.0003787-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: