Provider Demographics
NPI:1760729008
Name:ROWSE, MARY BETH (PCC-S)
Entity Type:Individual
Prefix:
First Name:MARY BETH
Middle Name:
Last Name:ROWSE
Suffix:
Gender:F
Credentials:PCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N CLEVELAND MASSILLON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2484
Mailing Address - Country:US
Mailing Address - Phone:330-310-9878
Mailing Address - Fax:877-350-0335
Practice Address - Street 1:300 N CLEVELAND MASSILLON RD STE 104
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2484
Practice Address - Country:US
Practice Address - Phone:330-310-9878
Practice Address - Fax:877-350-0335
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 103TM1800X
OHE. 0004301101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities