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NPI Code Detail

MEDICARE: THOMAS EDWARD NEMEROVSKY M.ED., PCC, LCDC III

MEDICARE:   THOMAS EDWARD NEMEROVSKY  M.ED., PCC, LCDC III
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE0501177OH
2101YA0400XAddiction (Substance Use Disorder) Counselor081166OH

General Provider Information

NPI Number : 1508035809
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS EDWARD NEMEROVSKY M.ED., PCC, LCDC III
Provider Business Mailing Address
First Line : 926 CARRIAGE LN
Second Line :
City : WOOSTER
State : OH
Zip : 44691-5430
Country : US
Telephone Number : 330-345-8013
Fax Number :
Provider Business Practice Location Address
First Line : 104 SPINK ST
Second Line :
City : WOOSTER
State : OH
Zip : 44691-3652
Country : US
Telephone Number : 330-264-8498
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2008
Last Update Date : 09/14/2012

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Directions to “ THOMAS EDWARD NEMEROVSKY M.ED., PCC, LCDC III” Practice Location

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