Healthcare Provider Details

I. General information

NPI: 1831056001
Provider Name (Legal Business Name): ALLISON AUGUSTINE CT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 FRANKLIN ST SE
WARREN OH
44483-5715
US

IV. Provider business mailing address

211 FAWN LN
CORTLAND OH
44410-2608
US

V. Phone/Fax

Practice location:
  • Phone: 330-372-2220
  • Fax: 330-372-2260
Mailing address:
  • Phone: 330-718-3618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2607444-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: