Provider Demographics
NPI:1669712394
Name:NOVAK, EDWARD THOMAS (LPCC)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:THOMAS
Last Name:NOVAK
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1653 MERRIMAN RD
Mailing Address - Street 2:212
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5210
Mailing Address - Country:US
Mailing Address - Phone:330-283-3650
Mailing Address - Fax:
Practice Address - Street 1:1653 MERRIMAN RD
Practice Address - Street 2:212
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5210
Practice Address - Country:US
Practice Address - Phone:330-283-3650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-16
Last Update Date:2013-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002426101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional