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General NPI Number Information
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NPI Number | 1285687897
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Entity Type | Organization
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Legal Business Name | WESTERN RESERVE COUNSELING SERVICE, INC.
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 VICTORIA PL SUITE 105
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City | PAINESVILLE
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State | OH
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Zip | 44077-3406
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Country | US
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Telephone | 440-352-8954
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Fax | 440-352-0351
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Provider Business Mailing Address
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Address Line | 1 VICTORIA PL SUITE 105
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City | PAINESVILLE
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State | OH
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Zip | 44077-3406
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Country | US
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Telephone | 440-352-8954
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Fax | 440-352-0351
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. VINCENT P. PINTO
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Credential | LISW, ACSW, BCD
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Telephone | 440-352-8954
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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 | 103
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License Number State | OH
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