Healthcare Provider Details

I. General information

NPI: 1801772397
Provider Name (Legal Business Name): CARLOS CHARLES RWEBOGORA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 E EXCHANGE ST FL 6
AKRON OH
44308-1541
US

IV. Provider business mailing address

660 E BUCHTEL AVE
AKRON OH
44304-1935
US

V. Phone/Fax

Practice location:
  • Phone: 234-334-3293
  • Fax:
Mailing address:
  • Phone: 234-377-8181
  • Fax: 234-377-8181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2608094-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: