| Tina Rose-matheson, MA, ED, PCC | |
|
4641 Fulton Dr Nw, Canton, OH 44718-2384 | |
| (330) 433-6075 | |
| (330) 494-0299 |
| Full Name | Tina Rose-matheson |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 4641 Fulton Dr Nw, Canton, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346365384 | NPI | - | NPPES |
| 0175056 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | E0004230 (Ohio) | Secondary |
| 101YP2500X | Counselor - Professional | E0004230 (Ohio) | Primary |
| Entity Name | Child And Adolescent Behavioral Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831172576 PECOS PAC ID: 2264712694 Enrollment ID: O20161201000343 |
| Mailing Address | Practice Location Address |
|---|---|
| Tina Rose-matheson, MA, ED, PCC 5480 Pigeon Run Rd Sw, Navarre, OH 44662-9612 Ph: (330) 305-1668 | Tina Rose-matheson, MA, ED, PCC 4641 Fulton Dr Nw, Canton, OH 44718-2384 Ph: (330) 433-6075 |
Joseph N Lockett, LICDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1341 Market Ave N, Canton, OH 44714 Phone: 330-453-8252 Fax: 330-453-6716 | |
Amy Nelson, CT, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1341 Market Ave N, Canton, OH 44714 Phone: 330-453-8252 | |
Hillary A Whiteman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1341 Market Ave N, Canton, OH 44714 Phone: 330-453-8252 Fax: 330-453-6716 | |
Brendan Rowe, CT Counselor Medicare: Not Enrolled in Medicare Practice Location: 624 Market Ave N, Canton, OH 44702 Phone: 330-493-4553 Fax: 330-493-3761 | |
Obiageri Ebere Ngwaogu, CT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1341 Market Ave N, Canton, OH 44714 Phone: 330-453-8252 Fax: 330-452-4655 | |
Alexis Mutersbaugh, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4522 Fulton Dr Nw, Canton, OH 44718 Phone: 330-915-2907 Fax: 330-915-2958 | |
Kelli N Mann, PCC Counselor Medicare: Medicare Enrolled Practice Location: 3745 Whipple Ave Nw Ste A, Canton, OH 44718 Phone: 330-331-7506 |