Healthcare Provider Details

I. General information

NPI: 1205803673
Provider Name (Legal Business Name): THE RELATIONSHIP CENTER OF NORTHEAST OHIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7023 MEARS GATE DR NW STE A
NORTH CANTON OH
44720-8849
US

IV. Provider business mailing address

2400 WALES AVE NW SUITE K
MASSILLON OH
44646-0804
US

V. Phone/Fax

Practice location:
  • Phone: 330-497-2452
  • Fax: 330-497-2749
Mailing address:
  • Phone: 330-833-2452
  • Fax: 330-833-2749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE-3108
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberF-068
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. TERESA ROGERS
Title or Position: OWNER
Credential: PHD
Phone: 330-497-2452