Healthcare Provider Details

I. General information

NPI: 1952061798
Provider Name (Legal Business Name): JOHN T WARMUS LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 S MAIN ST
COVENTRY TWP OH
44319-3028
US

IV. Provider business mailing address

3445 S MAIN ST
COVENTRY TWP OH
44319-3028
US

V. Phone/Fax

Practice location:
  • Phone: 330-644-4095
  • Fax: 330-645-2031
Mailing address:
  • Phone: 330-644-4095
  • Fax: 330-645-2031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC2103155-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2204190
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2404382
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: