Provider Demographics
NPI:1649661687
Name:SPECIALTY CARE COUNSELING SERVICES, LTD
Entity type:Organization
Organization Name:SPECIALTY CARE COUNSELING SERVICES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:SARGIOUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-393-5566
Mailing Address - Street 1:2000 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6156
Mailing Address - Country:US
Mailing Address - Phone:330-399-1221
Mailing Address - Fax:330-399-1205
Practice Address - Street 1:2000 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6156
Practice Address - Country:US
Practice Address - Phone:330-399-1221
Practice Address - Fax:330-399-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03221601261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health