Healthcare Provider Details

I. General information

NPI: 1952322349
Provider Name (Legal Business Name): SUSAN Y MARK-SRACIC MS IN ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 BELMONT AVE
YOUNGSTOWN OH
44505-2405
US

IV. Provider business mailing address

1346 VALLEY VIEW DR
YOUNGSTOWN OH
44512-3751
US

V. Phone/Fax

Practice location:
  • Phone: 330-744-3320
  • Fax: 330-744-3677
Mailing address:
  • Phone: 330-629-6186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberS-0017755
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS-0017755
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberS-0017755
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: