Healthcare Provider Details

I. General information

NPI: 1952226946
Provider Name (Legal Business Name): CITY CARE COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 S LEXINGTON SPRINGMILL RD
MANSFIELD OH
44906-3315
US

IV. Provider business mailing address

636 S LEXINGTON SPRINGMILL RD
MANSFIELD OH
44906-3315
US

V. Phone/Fax

Practice location:
  • Phone: 419-214-1260
  • Fax: 419-214-1270
Mailing address:
  • Phone: 419-214-1260
  • Fax: 419-214-1270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JEREMY SMITH
Title or Position: EXECUTIVE DIRECTOR
Credential: LPCC-S
Phone: 419-214-1260