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General NPI Number Information
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NPI Number | 1336976521
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Entity Type | Organization
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Legal Business Name | SIMPLY AMAZING FAMILY ENVIRONMENT
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 9217 STATE ROUTE 43 STE 220
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City | STREETSBORO
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State | OH
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Zip | 44241-5371
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Country | US
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Telephone | 330-422-9005
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Fax |
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Provider Business Mailing Address
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Address Line | 9150 MARKET SQUARE DR STE 201
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City | STREETSBORO
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State | OH
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Zip | 44241-4573
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Country | US
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Telephone | 330-422-9005
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | SEREENA CREAMER
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Credential | LPCC-S
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Telephone | 330-422-9005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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