| Creekside Counseling Center, Llc | |
|
106 S Broad St Canfield OH 44406-1447 | |
| (330) 533-5450 | |
| (330) 533-4292 |
| Full Name | Creekside Counseling Center, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 106 S Broad St, Canfield, Ohio |
| Authorized Official Name and Position | Thomas Richard Kupec (CHIEF EXCUTIVE MANAGER) |
| Authorized Official Contact | 3305335450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Counseling Center, Llc 106 S Broad St Canfield OH 44406-1447 Ph: (330) 533-5450 | Creekside Counseling Center, Llc 106 S Broad St Canfield OH 44406-1447 Ph: (330) 533-5450 |
| NPI Number | 1922126168 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922126168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | E-0003444-SUPV (Ohio) | Primary |
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