Healthcare Provider Details

I. General information

NPI: 1487564795
Provider Name (Legal Business Name): COLENETTA WARNOCK SWT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 S MAIN ST
AKRON OH
44301-1664
US

IV. Provider business mailing address

3445 S MAIN ST
COVENTRY TOWNSHIP OH
44319-3028
US

V. Phone/Fax

Practice location:
  • Phone: 330-644-4095
  • Fax:
Mailing address:
  • Phone: 330-644-4095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2605255-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: