Provider Demographics
NPI:1598546202
Name:GLADDEN, ROMETTA
Entity Type:Individual
Prefix:
First Name:ROMETTA
Middle Name:
Last Name:GLADDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 W MARKET ST STE 102
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7018
Mailing Address - Country:US
Mailing Address - Phone:216-457-3504
Mailing Address - Fax:
Practice Address - Street 1:1815 W MARKET ST STE 102
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7018
Practice Address - Country:US
Practice Address - Phone:330-730-0051
Practice Address - Fax:330-280-5115
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.187195101YA0400X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172V00000XOther Service ProvidersCommunity Health Worker