Provider Demographics
NPI:1851953905
Name:SUMMERS, GEORGE DELANO (MSED)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:DELANO
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1039
Mailing Address - Country:US
Mailing Address - Phone:330-793-2487
Mailing Address - Fax:330-743-5748
Practice Address - Street 1:711 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1039
Practice Address - Country:US
Practice Address - Phone:330-793-2487
Practice Address - Fax:330-743-5748
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2404122101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional