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General NPI Number Information
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NPI Number | 1427610591
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Entity Type | Individual
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Provider Name | ADAM REMINGTON LISW, LICDC
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Gender | Male
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 2737 YOUNGSTOWN RD SE
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City | WARREN
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State | OH
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Zip | 44484-5002
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Country | US
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Telephone | 330-369-8022
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Fax |
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Provider Business Mailing Address
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Address Line | 2737 YOUNGSTOWN RD SE
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City | WARREN
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State | OH
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Zip | 44484-5002
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Country | US
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Telephone | 330-369-8022
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 170095
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2405630
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License Number State | OH
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