Provider Demographics
NPI:1609043454
Name:SUSAN CALAWAY & ASSOCIATES COUNSELING SERVICES
Entity Type:Organization
Organization Name:SUSAN CALAWAY & ASSOCIATES COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CALAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:330-798-1220
Mailing Address - Street 1:2161 EASTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2179
Mailing Address - Country:US
Mailing Address - Phone:330-798-1220
Mailing Address - Fax:330-798-1225
Practice Address - Street 1:2161 EASTWOOD AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2179
Practice Address - Country:US
Practice Address - Phone:330-798-1220
Practice Address - Fax:330-798-1225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLISW # 0002279251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCASW22751Medicare PIN