Provider Demographics
NPI:1154095271
Name:AUSTIN COUNSELING CENTER FOR WOMEN & FAMILIES
Entity Type:Organization
Organization Name:AUSTIN COUNSELING CENTER FOR WOMEN & FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIANNE
Authorized Official - Middle Name:SKROVAN
Authorized Official - Last Name:MASSIMO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:440-213-2906
Mailing Address - Street 1:4938 GLENRIDGE CIR NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44714-1135
Mailing Address - Country:US
Mailing Address - Phone:440-213-2906
Mailing Address - Fax:
Practice Address - Street 1:4938 GLENRIDGE CIR NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44714-1135
Practice Address - Country:US
Practice Address - Phone:440-213-2906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)