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General NPI Number Information
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NPI Number | 1326422072
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Entity Type | Individual
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Provider Name | JASON GRECH LPC
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Gender | Male
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/25/2021
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Provider Practice Location Address
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Address Line | 223 W MAIN ST
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City | RAVENNA
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State | OH
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Zip | 44266-2741
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Country | US
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Telephone | 330-577-4099
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Fax |
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Provider Business Mailing Address
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Address Line | 305 HIGHLAND AVE
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City | KENT
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State | OH
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Zip | 44240-2522
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Country | US
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Telephone | 330-221-1396
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.2103162
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License Number State | OH
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