Provider Demographics
NPI:1003098674
Name:ATHANS, JAMES M (PCC/S, LICDC, SAP)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:ATHANS
Suffix:
Gender:M
Credentials:PCC/S, LICDC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 EAST EXCHANGE ST
Mailing Address - Street 2:GREENLEAF FAMILY CENTER
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1273
Mailing Address - Country:US
Mailing Address - Phone:330-376-9494
Mailing Address - Fax:330-376-4525
Practice Address - Street 1:212 EAST EXCHANGE ST
Practice Address - Street 2:GREENLEAF FAMILY CENTER
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1273
Practice Address - Country:US
Practice Address - Phone:330-376-9494
Practice Address - Fax:330-376-4525
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0004055101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor