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General NPI Number Information
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NPI Number | 1851864219
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Entity Type | Organization
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Legal Business Name | CLINIC OF INDIVIDUAL AND FAMILY COUNSELING
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Dates
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Enumeration Date | 01/09/2019
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 27 SOUTH FORGE STREET
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City | AKRON
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State | OH
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Zip | 44325-5007
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Country | US
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Telephone | 330-972-6822
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Fax | 330-972-5599
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Provider Business Mailing Address
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Address Line | 27 SOUTH FORGE STREET
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City | AKRON
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State | OH
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Zip | 44325-5007
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Country | US
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Telephone | 330-972-6822
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Fax | 330-972-5599
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Authorized Official
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Title or Position | EXEC, VP & CHIEF ADMIN. OFFICER
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Name | REX RAMSIER
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Credential |
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Telephone | 330-972-7593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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