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General NPI Number Information
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NPI Number | 1093856494
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Entity Type | Organization
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Legal Business Name | SUMMIT THERAPY CENTER LLC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 4419 CLEVELAND RD
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City | WOOSTER
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State | OH
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Zip | 44691-1233
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Country | US
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Telephone | 330-345-8450
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Fax | 330-345-5899
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Provider Business Mailing Address
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Address Line | 4419 CLEVELAND RD
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City | WOOSTER
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State | OH
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Zip | 44691-1233
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Country | US
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Telephone | 330-345-8450
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Fax | 330-345-5899
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | CHEVELLE SNYDER
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Credential |
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Telephone | 419-464-6907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E0008036
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | I7261
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S-0018817
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S-0012173
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License Number State | OH
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