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General NPI Number Information
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NPI Number | 1184140998
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Entity Type | Individual
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Provider Name | MIKE PATRICK RAGAN LCDC III, BA
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Gender | Male
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 08/15/2017
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Provider Practice Location Address
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Address Line | 40 E GLENWOOD AVE
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City | AKRON
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State | OH
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Zip | 44304-1136
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Country | US
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Telephone | 330-996-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 1306 PORTAGE ST NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-2212
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Country | US
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Telephone | 330-499-5404
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 141182
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License Number State | OH
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