MEDICARE: SIMPLY AMAZING FAMILY ENVIRONMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	261QM0850X	Adult Mental Health Clinic/Center
4	261QM0855X	Adolescent and Children Mental Health Clinic/Center
5	261QM1300X	Multi-Specialty Clinic/Center
6	251B00000X	Case Management Agency
7	276400000X	Substance Use Disorder Rehabilitation Hospital Unit
8	101YA0400X	Addiction (Substance Use Disorder) Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336976521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMPLY AMAZING FAMILY ENVIRONMENT

Provider Business Mailing Address
First Line	:	9150 MARKET SQUARE DR STE 201
Second Line	:
City	:	STREETSBORO
State	:	OH
Zip	:	44241-4573
Country	:	US
Telephone Number	:	330-422-9005
Fax Number	:

Provider Business Practice Location Address
First Line	:	9217 STATE ROUTE 43 STE 220
Second Line	:
City	:	STREETSBORO
State	:	OH
Zip	:	44241-5371
Country	:	US
Telephone Number	:	330-422-9005
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	SEREENA CREAMER
Credential	:	LPCC-S
Telephone Number	:	330-422-9005

Provider Enumeration Date	:	09/19/2024
Last Update Date	:	04/09/2025

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Directions to “SIMPLY AMAZING FAMILY ENVIRONMENT ” Practice Location

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