Healthcare Provider Details

I. General information

NPI: 1699730499
Provider Name (Legal Business Name): CATHOLIC CHARITIES COMMUNITY SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 NORTH MAIN STREET
AKRON OH
44310-3017
US

IV. Provider business mailing address

812 BIRUTA STREET
AKRON OH
44307-1104
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-7481
  • Fax: 330-762-7484
Mailing address:
  • Phone: 330-762-7481
  • Fax: 330-762-7484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0162
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0162
License Number StateOH

VIII. Authorized Official

Name: MR. DONALD P. FINN
Title or Position: DIRECTOR
Credential: DIRECTOR
Phone: 330-762-7481