Healthcare Provider Details

I. General information

NPI: 1427405695
Provider Name (Legal Business Name): STEPHANIE SANDERS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2016
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COMMUNITY SUPPORT SERVICES, INC. 150 CROSS ST
AKRON OH
44311-1026
US

IV. Provider business mailing address

COMMUNITY SUPPORT SERVICES, INC. 150 CROSS ST
AKRON OH
44311-1026
US

V. Phone/Fax

Practice location:
  • Phone: 330-253-9388
  • Fax: 330-376-6726
Mailing address:
  • Phone: 330-253-9388
  • Fax: 330-376-6726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0003896
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.001388
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0003896-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: