Healthcare Provider Details
I. General information
NPI: 1730158692
Provider Name (Legal Business Name): VALLEY COUNSELING SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2006
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 E MARKET ST
WARREN OH
44481-1141
US
IV. Provider business mailing address
150 E MARKET ST
WARREN OH
44481-1141
US
V. Phone/Fax
- Phone: 330-394-6244
- Fax:
- Phone: 330-394-6244
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
TIMOTHY
SCHAFFNER
Title or Position: PRESIDENT & CEO
Credential: MHA
Phone: 330-394-6244