Healthcare Provider Details

I. General information

NPI: 1235154071
Provider Name (Legal Business Name): WARREN PSYCHIATRIC CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 LOGAN WAY
HUBBARD OH
44425-3311
US

IV. Provider business mailing address

4505 LOGAN WAY
HUBBARD OH
44425-3311
US

V. Phone/Fax

Practice location:
  • Phone: 330-259-3664
  • Fax: 330-259-3665
Mailing address:
  • Phone: 330-259-3664
  • Fax: 330-259-3665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number StateOH
# 7
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. DHARL CHINTAN
Title or Position: ADMINISTRATOR
Credential: LSW
Phone: 330-716-5144