Provider Demographics
NPI:1629782792
Name:NEUROWISE THERAPEUTICS LLC
Entity Type:Organization
Organization Name:NEUROWISE THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HARSHBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:330-217-3488
Mailing Address - Street 1:2425 MEDINA RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5381
Mailing Address - Country:US
Mailing Address - Phone:330-353-9776
Mailing Address - Fax:
Practice Address - Street 1:2425 MEDINA RD STE 204
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5381
Practice Address - Country:US
Practice Address - Phone:330-353-9776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty