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General NPI Number Information
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NPI Number | 1649186792
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Entity Type | Organization
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Legal Business Name | THRESHOLD THERAPY GROUP LLC
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 3918 CLOCK POINTE TRL STE 105
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City | STOW
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State | OH
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Zip | 44224-2989
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Country | US
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Telephone | 760-593-8011
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Fax |
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Provider Business Mailing Address
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Address Line | 3918 CLOCK POINTE TRL STE 105
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City | STOW
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State | OH
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Zip | 44224-2989
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Country | US
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Telephone | 760-593-8011
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MATTHEW L NELSON
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Credential | LISW, LICDC
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Telephone | 760-593-8011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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