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General NPI Number Information
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NPI Number | 1144825654
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Entity Type | Organization
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Legal Business Name | REJUVENATE YOU COUNSELING, LLC
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 11/14/2021
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Provider Practice Location Address
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Address Line | 25 N CANFIELD NILES RD STE 80
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City | AUSTINTOWN
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State | OH
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Zip | 44515-2308
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Country | US
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Telephone | 307-799-1580
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Fax | 330-953-2282
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Provider Business Mailing Address
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Address Line | 25 N CANFIELD NILES RD STE 80
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City | AUSTINTOWN
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State | OH
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Zip | 44515-2308
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Country | US
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Telephone | 330-779-1580
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Fax | 330-953-2282
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Authorized Official
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Title or Position | OWNER/CEO/PSYCHOTHERAPIST
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Name | MISS JACQUELINE ELAINE GLAROS
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Credential | LPCC-S
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Telephone | 330-779-1580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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