Provider Demographics
NPI:1932264785
Name:PROFESSIONAL PERSPECTIVES PARTNERSHIP, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL PERSPECTIVES PARTNERSHIP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:PROSPERO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-492-8494
Mailing Address - Street 1:4450 BELDEN VILLAGE ST NW
Mailing Address - Street 2:STE. 202
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2596
Mailing Address - Country:US
Mailing Address - Phone:330-492-8494
Mailing Address - Fax:330-492-8294
Practice Address - Street 1:4450 BELDEN VILLAGE ST NW
Practice Address - Street 2:STE. 202
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2596
Practice Address - Country:US
Practice Address - Phone:330-492-8494
Practice Address - Fax:330-492-8294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4438103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0215378Medicaid
OH0215378Medicaid