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General NPI Number Information
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NPI Number | 1053909077
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Entity Type | Organization
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Legal Business Name | CONNECTIONS COUNSELING & MEDIATION SERVICES, LLC
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Dates
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Enumeration Date | 01/05/2021
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 3637 MEDINA RD STE 345A
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City | MEDINA
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State | OH
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Zip | 44256-8152
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Country | US
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Telephone | 216-346-2578
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Fax | 330-952-1008
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Provider Business Mailing Address
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Address Line | 3637 MEDINA RD STE 345A
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City | MEDINA
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State | OH
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Zip | 44256-8152
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Country | US
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Telephone | 216-346-2578
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Fax | 330-952-1008
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MRS. COURTNEY MICHELLE OTT
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Credential | LISW-S
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Telephone | 216-346-2578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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