Provider Demographics
NPI:1275290181
Name:SUMMERS, LINDA R (CDCA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 COURTLAND DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4612
Mailing Address - Country:US
Mailing Address - Phone:330-329-2040
Mailing Address - Fax:
Practice Address - Street 1:1970 COURTLAND DR
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-4612
Practice Address - Country:US
Practice Address - Phone:330-329-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-27
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.178482101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)