| Specialty Care Counseling Services, Ltd | |
|
2000 E Market St Warren OH 44483-6156 | |
| (330) 399-1221 | |
| (330) 399-1205 |
| Full Name | Specialty Care Counseling Services, Ltd |
|---|---|
| Speciality | Counselor |
| Location | 2000 E Market St, Warren, Ohio |
| Authorized Official Name and Position | Ehab Sargious (PSYCHIATRIST/OWNER) |
| Authorized Official Contact | 3303991221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialty Care Counseling Services, Ltd 2000 E Market St Warren OH 44483-6156 Ph: (330) 399-1221 | Specialty Care Counseling Services, Ltd 2000 E Market St Warren OH 44483-6156 Ph: (330) 399-1221 |
| NPI Number | 1972551141 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5294787701 |
|---|---|
| Medicare Enrollment ID | O20050214000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972551141 | NPI | - | NPPES |
| 459827 | Other | OH | VALUE OPTIONS GROUP NUMBE |
| 2268719 | Medicaid | OH | |
| 0540 | Other | OH | ST. OF OH. CERT. # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0540 (Ohio) | Primary |
| Provider Name | Ehab L Sargious |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619968427 PECOS PAC ID: 1456303965 Enrollment ID: I20061120000542 |
| Provider Name | Keith Yale Burger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972591998 PECOS PAC ID: 5698774081 Enrollment ID: I20061213000037 |
| Provider Name | Virginia R Daley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003195546 PECOS PAC ID: 9739351636 Enrollment ID: I20111019000736 |
| Provider Name | Susan M Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336470715 PECOS PAC ID: 3678884459 Enrollment ID: I20150619001774 |
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