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General NPI Number Information
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NPI Number | 1457231185
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Entity Type | Individual
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Provider Name | MACY JEAN METZGER
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Gender | Female
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 6614 SOUTHERN BLVD BLDG E
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City | BOARDMAN
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State | OH
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Zip | 44512-3455
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Country | US
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Telephone | 330-543-5015
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Fax |
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Provider Business Mailing Address
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Address Line | 3365 PARTRIDGE PARK DR
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City | POLAND
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State | OH
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Zip | 44514-2808
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Country | US
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Telephone | 330-301-5106
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2506756
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License Number State | OH
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