Provider Demographics
NPI:1790819852
Name:PASTORAL COUNSELING SERVICE OF SUMMIT COUNTY
Entity Type:Organization
Organization Name:PASTORAL COUNSELING SERVICE OF SUMMIT COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF ACCOUNT REC
Authorized Official - Prefix:
Authorized Official - First Name:LESLI
Authorized Official - Middle Name:
Authorized Official - Last Name:EISENHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-996-4600
Mailing Address - Street 1:611 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1406
Mailing Address - Country:US
Mailing Address - Phone:330-996-4600
Mailing Address - Fax:330-564-9296
Practice Address - Street 1:611 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-1406
Practice Address - Country:US
Practice Address - Phone:330-996-4600
Practice Address - Fax:330-564-9296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH44-19Medicaid
OH10032Medicare UPIN