Healthcare Provider Details

I. General information

NPI: 1184496747
Provider Name (Legal Business Name): KAIROS WELLNESS CENTER, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 AKRON PENINSULA RD STE A
AKRON OH
44313-7931
US

IV. Provider business mailing address

1611 AKRON PENINSULA RD STE A
AKRON OH
44313-7931
US

V. Phone/Fax

Practice location:
  • Phone: 330-767-9758
  • Fax:
Mailing address:
  • Phone: 330-767-9758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: APRIL N YOUNG
Title or Position: MENTAL HEALTH THERAPIST
Credential: LPCC-S, MFT
Phone: 330-696-2647