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General NPI Number Information
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NPI Number | 1336253079
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Entity Type | Individual
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Provider Name | CHARLES MICHAEL SABAKA LPCC
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3118 CLEVELAND AVE NW
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City | CANTON
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State | OH
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Zip | 44709-2813
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Country | US
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Telephone | 330-492-9913
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Fax | 330-492-6561
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Provider Business Mailing Address
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Address Line | 129 34TH ST NW
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City | CANTON
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State | OH
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Zip | 44709
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Country | US
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Telephone | 330-493-6291
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E0002100
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License Number State | OH
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