Provider Demographics
NPI:1245946052
Name:SAFFRAN, MARK (CDCA)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:SAFFRAN
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 WINDSOR CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-7339
Mailing Address - Country:US
Mailing Address - Phone:216-272-3375
Mailing Address - Fax:
Practice Address - Street 1:105 5TH ST SE STE 5
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-4257
Practice Address - Country:US
Practice Address - Phone:234-280-2358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH812546101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)