Healthcare Provider Details

I. General information

NPI: 1013826130
Provider Name (Legal Business Name): COLOR OUTSIDE THE LINES COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 FRANKLIN AVE STE 222
KENT OH
44240-4383
US

IV. Provider business mailing address

1640 FRANKLIN AVE STE 222
KENT OH
44240-4383
US

V. Phone/Fax

Practice location:
  • Phone: 216-570-0298
  • Fax:
Mailing address:
  • Phone: 216-570-0298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: RAVEN THOMAS
Title or Position: OWNER
Credential:
Phone: 216-570-0298