Provider Demographics
NPI:1811203888
Name:COUNSELING AND PSYCHOLOGICAL ASSOC. LLC
Entity Type:Organization
Organization Name:COUNSELING AND PSYCHOLOGICAL ASSOC. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PERKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:330-666-4541
Mailing Address - Street 1:1683 N HAMETOWN RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-1059
Mailing Address - Country:US
Mailing Address - Phone:330-666-4541
Mailing Address - Fax:
Practice Address - Street 1:1683 N HAMETOWN RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-1059
Practice Address - Country:US
Practice Address - Phone:330-666-4541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00005521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPESW09551Medicare PIN