# DOCTORS PAIN CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386698215
- **Authorized official:** TRACY LEE NEUENDORF D.O. (PRESIDENT/CEO/OWNER)
- **Authorized official phone:** (330) 629-2888

## Contact information

- **Practice address:** 1011 BOARDMAN CANFIELD RD, BOARDMAN, OH 44512
- **Practice address phone:** (330) 629-2888
- **Practice address fax:** (330) 259-9625
- **Mailing address:** 1011 BOARDMAN CANFIELD RD, BOARDMAN, OH 44512-4226
- **Mailing address phone:** (330) 629-2888
- **Mailing address fax:** (330) 629-2946

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 364SP0808X | Psychiatric/Mental Health Clinical Nurse Specialist | — | NULL | — |
| 364SP0808X | Psychiatric/Mental Health Clinical Nurse Specialist | — | — | — |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 08/21/2018