Provider Demographics
NPI:1578137451
Name:INTERA COUNSELING AND WELLNESS LLC
Entity Type:Organization
Organization Name:INTERA COUNSELING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPOSO
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:330-906-6432
Mailing Address - Street 1:1580 POPPY DR NW
Mailing Address - Street 2:
Mailing Address - City:MOGADORE
Mailing Address - State:OH
Mailing Address - Zip Code:44260-1717
Mailing Address - Country:US
Mailing Address - Phone:330-906-6432
Mailing Address - Fax:
Practice Address - Street 1:3333 MASSILLON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5981
Practice Address - Country:US
Practice Address - Phone:330-906-6432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0188684Medicaid