Provider Demographics
NPI:1740560655
Name:HOLBEN, ABENA K (LPC)
Entity Type:Individual
Prefix:
First Name:ABENA
Middle Name:K
Last Name:HOLBEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13298 FERN AVE NW
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-9625
Mailing Address - Country:US
Mailing Address - Phone:216-312-3100
Mailing Address - Fax:
Practice Address - Street 1:2600 TUSCARAWAS ST W STE 340
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-4694
Practice Address - Country:US
Practice Address - Phone:330-493-9607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA. 08140225200000X
OHC.2304948101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant