Provider Demographics
NPI:1821852708
Name:CONNECTION WITH INTENTION, LLC
Entity Type:Organization
Organization Name:CONNECTION WITH INTENTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LISW-S, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-969-5983
Mailing Address - Street 1:PO BOX 1130
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-0130
Mailing Address - Country:US
Mailing Address - Phone:440-969-5983
Mailing Address - Fax:
Practice Address - Street 1:924 DEVONSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SHEFFIELD LAKE
Practice Address - State:OH
Practice Address - Zip Code:44054-2000
Practice Address - Country:US
Practice Address - Phone:440-969-5983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty